Hubungan Derajat Berat Disfagia dengan Perbaikan Derajat Stroke pada Pasien Stroke Iskemik Akut di RSUD Dr. Moewardi Surakarta

Ira Ristinawati, OS Hartanto, Hari Wujoso, Subandi Subandi

Abstract

Pendahuluan: Stroke masih merupakan penyebab mortalitas dan morbiditas yang tinggi di seluruh dunia. Pasien stroke sering mengalami disfagia terutama pada fase akut. Prosedur penilaian yang mudah diterapkan untuk menilai disfagia pada pasien stroke penting dilakukan untuk mencegah komplikasi yang bisa terjadi akibat disfagia, yaitu dengan menggunakan skor GUSS (Gugging Swalowing Screen).

Metode: Penelitian ini adalah penelitian kuantitatif analitik observasional dengan pendekatan cross sectional, dengan populasi sampel pasien stroke iskemik akut yang rawat inap pada periode bulan Januari-Maret 2020, didapatkan jumlah subjek penelitian 33 yang sesuai dengan kriteria inklusi dan eksklusi yang telah ditentukan. Uji korelasi pearson dan spearman digunakan untuk menganalisis data dalam penelitian ini.

Hasil: Terdapat hubungan yang signifikan secara statistik antara disfagia dengan perbaikan derajat stroke pada pasien stroke iskemik akut dengan nilai p=0,002 (p<0.05) yang mempunyai korelasi sedang (r=0,530) di RSUD Dr.Moewardi Surakarta. Selain itu juga terdapat hubungan yang signifikan secara statistik antara keparahan disfagia dengan pneumonia dengan nilai p=0.001 (p<0.005)

Kesimpulan: Terdapat hubungan antara disfagia dengan perbaikan derajat stroke pada pasien stroke iskemik akut di RSUD Dr.Moewardi Surakarta.

 

Kata Kunci: stroke iskemik akut, disfagia, NIHSS, skor GUSS, perbaikan derajat stroke.

Introduction: Stroke has high mortality and morbidity rates in the world. Stroke patients often experience dysphagia, especially in the acute phase. An easy assessment procedure applied to assess dysphagia in stroke patients is important to prevent complications that can occur due to dysphagia, namely by using a GUSS (Gugging Swalowing Screen) score.

Methods: This study was a quantitative observational analytic study with a cross sectional design, with a sample population of acute ischemic stroke patients who were hospitalized in the period January-March 2020, obtained the number of subjects 33 in accordance with the specified inclusion and exclusion criteria. Pearson and Spearman correlation tests were used to analyze the data in this study.

Results: There was a statistically significant relationship between dysphagia and stroke improvement in patients with acute ischemic stroke with p value = 0.002 (p <0.05) which had a moderate correlation (r = 0.530) in Dr.Moewardi Hospital Surakarta. There was also a statistically significant relationship between the severity of dysphagia and pneumonia with p value = 0.001 (p <0.005)

Conclusion: There is a relationship between dysphagia and improvement in the degree of stroke in patients with acute ischemic stroke in RSUD Dr.Moewardi Surakarta.

 

Keywords: acute ischemic stroke, dysphagia, NIHSS, GUSS score, stroke improvement.

Keywords

acute ischemic stroke, dysphagia; NIHSS; GUSS score; stroke improvement

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References

World Health Organization (WHO). 2017. Cardiovascular Disease (CVDs). https://www.who.int/en/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds). Diakses 12 Maret 2019. 2. Sujatha, Rajaragupathy dan Kavitha S. 2017. Atherogenic Indices in Stroke Patients: A Retrospective Study. Iran J Neurol: 16(2): 78-82. 3. Sack D, Black CM, Cognard C, Connors JJ III. 2013. Multisociety Consensus Quality Improvement Guidelines for Intraarterial Catheter-Directed Treatment of Acute Ischemic Stroke, from the American Society of Neuroradiology, Canadian Interventional Radiology Association, Cardiovascular and Interventional Radiological Society of Europe, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of NeuroInterventional Surgery, European Society of Minimally Invasive Neurological Therapy, and Society of Vascular and Interventional Neurology. J Vasc Interv Radiol: 24:151–63. 4. Kementerian Kesehatan RI. 2013. Riset Kesehatan Dasar. Jakarta. 5. Kementerian Kesehatan RI. 2018. Riset Kesehatan Dasar. Jakarta. 6. Hankey, Graeme J, et al. 2019. Warlow’s Stroke: Practical Management. 4th edition. London: Wiley Blackwell. 7. Perry L, Love CP. 2001. Screening for dysphagia and aspiration in acute stroke: a system review. Dysphagia. 2001;16:7–18. 8. Almatsier, Sunita. 2004. Prinsip Dasar Ilmu Gizi. Jakarta: Gramedia Pustaka Utama. 9. Harris, Salim dan Kurniawan M. 2016. CODE STROKE: Perpaduan Implementasi Terapi Reperfusi Stroke Iskemik di Indonesia. Jakarta: Departemen Neurologi Fakultas Kedokteran Universitas Indonesia. 10. Fonarow G.C, Jeffrey L. Saver, Eric E. Smith., et al. 2012. Relationship of National Institutes of Health Stroke Scale to 30-Day Mortality in Medicare Beneficiaries With Acute Ischemic Stroke. Journal of the American Heart Association, Vol. 1, No. 1, February 2012. J Am Heart Assoc: 1:42-50. 11. PERDOSSI. 2008. Modul Induk Neurovaskuler. Jakarta: Perhimpunan Dokter Spesialis Saraf Indonesia. 12. Andersen UT, Beck AM, Kjaersgaard A, Hansen T, Poulsen, I. Systematic review and evidence based recommendations on texture modified foods and thickened fluids for adults (≥18 years) with oropharyngeal dysphagia. E-SPEN Journal. 2013;8:e127–e134. 13. Langdon PC, Lee AH, Binns CW. Dysphagia in acute ischaemic stroke: severity, recovery and relationship to stroke subtype. J Clin Neurosci. 2007;14(7):630–4. 14. Gandolfi M, Smania N, Bisoffi G, Squaquara T, Zuccher P, Mazzucco S. 2014. Improving Post-Stroke Dysphagia Outcomes Through a Standardized and Multidisciplinary Protocol : An Exploratory Cohort Study. 2014;704– 12. 15. Jeyaseelan K, Lim K.Y, Armugam, A. 2008. Neuroprotectants in Stroke Therapy. Expert Opin. Pharmacother: 9(6):887-900. 16. Tarraga, C.S, Steinhauer E.G, Caminal M.M, et al. 2018. Biological Age is a Predictor of Mortality in Ischemic Stroke. Scientific Reports:8:4148. 17. Nedeltchev K, Renz N, Karameshev A, Haefeli T, Brekenfeld C, Meier N, et al. 2010. Predictors of Early Mortality After Acute Ischaemic Stroke. Swiss Med Wkly;140(17-18):254-259. 18. Gibson C.L. 2013. Cerebral Ischemic Stroke: Is Gender Important? Journal of Cerebral Blood Flow and Metabolism. Journal of the International Society of Cerebral Blood Flow and Metabolism: 2013;33(9):1355–136. 19. Yang R.Z, Lee M.J, Hu H, Barbara, et al. 2013. Schematic Diagram of Proposed Pathophysiological Role of Adipocyte Derived A-SAA in Human Obesity. PLOS Medicine. 20. Vasilios K, Stella S, Sofia P, Zoe R, et al. 2010. Mechanisms of Obesity Induced Hypertension. Hypertension Research: 33: 386–93. 21. Samaneh Maysami, Michael J. Haley, Natalia Gorenkova, et al. 2015. Prolonged Diet-Induced Obesity in Mice Modifies the Inflammatory Response and Leads to Worse Outcome After Stroke. Journal of Neuroinflammation: 12:140. 22. Sun W, Huang Y, Xian Y, et al. 2017. Association of Body Mass Index with Mortality and Functional Outcome After Acute Ischemic Stroke. Scientific RepoRts; 7:2507. 23. Phan, H. T., C. L. Blizzard, M. J. Reeves, A. G. Thrift, D. Cadilhac, J. Sturm, E. Heeley, P. Otahal, V. Konstantinos, C. Anderson, P. Parmar, R. Krishnamurthi, S. Barker-Collo, V. Feigin, Y. Bejot, N. L. Cabral, A. Carolei, S. Sacco, N. Chausson, S. Olindo, P. Rothwell, C. Silva, M. Correia, R. Magalhaes, P. Appelros, J. Korv, R. Vibo, C. Minelli, and S. Gall. 2017. Sex Differences in Long-Term Mortality After Stroke in the INSTRUCT (INternational STRoke oUtComes sTudy): A Meta-Analysis of Individual Participant Data. Circ Cardiovasc Qual Outcomes 10. 24. Dziewas R, M Ritter, M Schilling, C Konrad, S Oelenberg, D G Nabavi, F Sto ̈gbauer, E B Ringelstein, P Lu ̈demann. 2004. Pneumonia in acute stroke patients fed by nasogastric tube. J Neurol Neurosurg Psychiatry 2004;75:852–856. doi: 10.1136/jnnp.2003.019075. 25. Mann G, McCullough GH, Rosenbek JC, Wertz RT, McCoy S, McCullough K: Utility of clinical swallowing examination measures for detecting aspiration post-stroke. J Speech Lang Hear Res 2005;48:1280–1293.

DOI: https://doi.org/10.13057/smj.v4i2.42116

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