KEJADIAN ABSES SEREBRI PADA PASIEN PJB SIANOTIK DI RS DR M DJAMIL PADANG

Diska Yulia Trisiana

Abstract


Abstract

Objective : Cyanotic CHD is a congenital disease, insidence tend to increased with time. At M Djamil Hospital there was 85 case in 2013-2015. Brain abscess is the complication that mostly found in patient that can be serious and fatal. The aim of this study is to identify characteristics and factors in the occurence of brain abscess in cyanotic CHD patients. Methods : This was a cross sectional study. Data were collected from medical records of cyanotic CHD patient who admitted at M Djamil Hospital from 2016 to 2018. Bivariate analysis using paired sample T test and chi square. Data were analyzed with SPSS. P value <0.05 were considered to be statistically significant. Result : A total 15 patient (14.5%) brain abscess of 104 cyanotic CHD were found. Majority patient were boys (67.3%). The subjects mean age was 4.95 years and the youngest age was 1 year old. Nutritional status (p=0.009), head circumference (p=0.005), cyanotic spell (p=0.028), blood gas analysis (p=0.005), and outcome (p=0.005) were significant related factors for brain abscess. Hemoglobin (16.65±3.57), leucocyte (18775±7749.28), hematocryte (54.87±7.90), oxygen saturation (59.93±9.21) were statistycally significant. The culture of abscess were no growth. 9 of 15 patient with brain abscess were died. Conclusion : poor nutritional status, microcephaly, cyanotic spell, metabolic asidosis, hemoglobine, leucocytosis, high hematocryte, and low peripheral oxygen saturation were the significant related factors to brain abscess in cyanotic CHD patients. No bacterial growth in abscess culture. Mortality was still high, sixty percent of brain abscess child were died.

Keywords: Brain abscess; cyanotic; congenital heart disease.

 

Abstrak

Tujuan : insiden pasien penyakit jantung bawaan siantoik semakin bertambah. Di RS Dr. M. Djamil Padang terdapat sebanyak 85 kasus selama tahun 2013-2015. Abses serebri merupakan komplikasi yang paling sering ditemukan dan dapat berakibat serius. Penelitian ini bertujuan mengidentifikasi karakteristik dan faktor yang berhubungan dengan kejadian abses serebri pada pasien PJB sianotik. Metode : suatu penelitian cross sectional, dengan pengumpulan data dari rekam medis pasien PJB sianotik di RS Dr. M. Djamil tahun 2016-2018. Analisis bivariate dengan uji T dan chi square. Kemaknaan signifikan pada p value <0.05. Hasil : total sejumlah 104 pasien PJB sianotik, 15 pasien (14,5%) mengalami abses serebri. Jenis kelamin laki-laki 67,3%. Rerata usia 4.95 tahun dan termuda usia 1 tahun. Faktor yang berhubungan signifikan yaitu status gizi (p=0.009), lingkar kepala (p=0.005), cyanotic spell (p=0.028), analisa gas darah (p=0.005) dan outcome (p=0.05). Hubungan signifikan kejadian abses serebri dengan kadar hemoglobin (16.65±3.57), leukosit (18775±7749.28), hematokrit (54.87±7.90), dan saturasi oksigen (59.93±9.21). Pada pemeriksaan kultur abses tidak ditemukan pertumbuhan mikroorganisme. Sebanyak 9 dari 15 pasien meninggal. Kesimpulan : status gizi buruk, mikrosefal, cyanotic spell, asidosis metabolic, kadar hemoglobin, leukosit, hemokonsentrasi, dan saturasi oksigen perifer rendah merupakan faktor-faktor yang berhubungan signifikan dengan kejadian abses serebri pada pasien PJB sianotik. Tidak ada pertumbuhan mikroorganisme pada kultur cairan abses. Mortalitas cukup tinggi, sebanyak 60% pasien meninggal.

Kata kunci : abses serebri; penyakit jantung bawaan; sianotik

Full Text:

PDF

References


Hermawan BJ, Hariyanto D, Aprilia D. Profil Penyakit Jantung Bawaan di Instalasi Rawat Inap Anak RSUP DR. M. Djamil Padang Periode Januari 2013-Desember 2015. JKA. 2018;7: 142-8

Ontoseno T. Iron Deficiency, Low Arterial Oxygen Saturation and High Hematocrit Level as a Major Micro-Environmental Risk Factors in The Development of Brain Abscess in Patients with Tetralogy Of Fallot. Folia Medica Indonesiana. 2004;40:86-9

Udayakumaran S. Forgotten? Not Yet. Cardiogenic Brain Abscess in Children: A Case Series-Based Review. World Neurosurg. 2017;107:124-9.

Mehnaz A, Syed AU, Saleem AS, Khalid CN. Clinical features and outcome of cerebral abscess in CHD. J Ayub Med Coll Abbotabad. 2006;18:21-4.

Moorthy RK, Rajshekhar V. Management of Brain Abscess: an Overview. Neurosurg Focus. 2008; 24: 1-6

Takeshita M, Kagawa M, Yonetani H, Izawa M, Yati S, Nakanishi T, et al. Risk factors for brain abscess in patients with congenital cyanotic heart disease. Neurol Med Chir. 1992;32:667-70.

Firdausy NQ, Murni IK, Triono A, Noormanto, Nugroho S. Low peripheral oxygen saturation as a risk factor for brain abscess in children with cyanotic CHD. Paediatr Indones. 2018;58: 252-6

Sabah Km, Chowdhury AW, Islam MS, Ahmed M, Amin G, Islam KN, et al. Cyanotic complex congenital heart disease presenting with brain abscess at the age of 19: A case report and review of literature. Bangladesh Heart Journal 2016;31: 41-5

Shrivastava S. Malnutrition in congenital heart disease. Indian Pediatrics. 2008:535-6.

Hariyanto D. Profil penyakit jantung bawaan di instalasi rawat inap anak RSUP Dr. M. Djamil Padang Januari 2008-Februari 2011. Sari Pediatri. 2012:14(3):152-7.

Bagaswoto HP, Asmara R, Mumpuni H. Brain abscess in young adult with double outlet right ventricle (DORV) : a case report. Acta cardiologica indonesiana 2016; 2 : 82-5

Muzumdar D., Jhawar S., Goel A. Brain abscess: An overview. Int J Surg. 2011;9:136-44.

Shahzad K, Hamid MH, Khan MA, Malik N, Maqbool S. Brain abscess in children. J Coll Physicians Surg Pak. 2005; 15: 609-11.




DOI: http://dx.doi.org/10.32883/hcj.v6i2.1185

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

 HUMAN CARE JOURNAL
Published by Universitas Fort De Kock, Bukittinggi, Indonesia

© Human Care Journal  e-ISSN : 2528-665X P-ISSN : 2685-5798

View Human Care Journal Stats