Hubungan Fibronektin Serum dengan Tingkat Kesadaran Menurut Klasifikasi CT-Marshall pada Pasien Cedera Otak Sedang dan Berat akibat Trauma
DOI:
https://doi.org/10.35790/ecl.v11i3.46563Abstract
Abstract: Traumatic brain injury (COT) is the main cause of brain damage in the young and productive age generations. Although there is no accurate biological markers for detecting brain damages so far, many studies about fibronectin have been reported as a promising biological marker. This study aimed to obtain the relationship between serum fibronectin and level of consciousness based on CT-Marshal in patients with moderate and severe COT. This was an observational and analytical study with a cross-sectional design. Samples that met the study criteria were taken sequentially from the study hospital without differentiating exposure status (serum fibronectin levels) or outcome (CT-Marshall category). The regression test on the main variable serum fibronectin levels with awareness using the CT-Marshall category was carried out and showed significant relationship between serum fibronectin level and the patient's CT-Marshall category. The higher the serum fibronectin level, the higher the patient's CT-Marshall category which meant that a patient had a degree of severity and poor consciousness. In conclusion, there is a significant relationship between serum fibronectin level and level of consciousness based on the CT-Marshall category in traumatic brain injury patients.
Keywords: traumatic brain injury; biological markers; fibronectin; level of consciousnes
Abstrak: Cedera otak akibat trauma (COT) merupakan penyebab utama kerusakan otak pada generasi muda dan usia produktif. Saat ini, belum terdapat penanda biologis yang akurat untuk mendeteksi kerusakan otak traumatik ataupun menilai prognosis terkait kerusakan otak traumatik namun perhatian terhadap penanda biologis telah meningkat akhir-akhir ini yaitu antara lain fibronektin. Penelitian ini bertujuan untuk mengetahui hubungan fibronektin serum dengan tingkat kesadaran menurut klasifikasi CT-Marshall pada pasien COT sedang dan berat. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Sampel yang memenuhi kriteria penelitian diambil berurutan dari rumah sakit tempat penelitian tanpa membedakan status paparan (kadar fibronektin serum) ataupun luaran (kategori CT-Marshall). Pengambilan data dilakukan hanya sekali untuk keseluruhan variabel selama masa pengumpulan data. Hasil uji regresi terhadap kadar fibronektin serum dengan kesadaran menggunakan kategori CT-Marshall mendapatkan adanya hubungan bermakna yaitu semakin tinggi kadar fibronektin serum, semakin tinggi pula kategori CT-Marshall pasien yang berarti pasien memiliki derajat keparahan dan kondisi kesadaran yang buruk. Simpulan penelitian ini ialah terdapat hubungan bermakna antara kadar fibronektin serum terhadap kesadaran menggunakan kategori CT-Marshall pada pasien cedera otak traumatik.
Kata kunci: cedera otak akibat trauma; penanda biologis; fibronektin; tingkat kesadaran
References
Japardi I. Cedera Kepala. Jakarta: PT Bhuana Ilmu Populer; 2004. p. 87-91.
Raj R. Prognostic models in traumatic brain injury. Helsinki: University of Helsinki;2014. p. 20.
Megasari PN. Polri Catat 6.707 Kasus Kecelakaan Sepanjang 2022, 452 Orang Tewas. detikNews Senin, 03 Okt 2022 09:21 WIB. Available from: https://news.detik.com/berita/d-6325521/polri-catat-6707-kasus-kecelakaan-sepanjang-2022-452-orang-tewas.
Rogers SL, Letourneau PC, Pech IV. The role of fibronectin in neural development. Dev Neurosci. 1989; 11(4–5):248–65.
Norton J, Barie PS. Surgery Basic Science and Clinical Evidence (2nd ed). New York: Springer; 2008. p. 461.
Kraus JF, McArthur DL. Epidemiology of brain injury. In: Neurology and Trauma. United states: Mc Graw Hill Co; 1996. p. 2-18.
Schmidt OI, Infanger M, Heyde CE, Ertel W, Stahel PF. The role of neuroinflammation in traumatic brain injury. Eur J Trauma. 2004;30(3):135-49.
Yang CJ, Candelario-Jalil E. Role of matrix metalloproteinases in brain edema (Chapter 11). In: Brain Edema: From Molecular Mechanisms to Clinical Practice. Elsevier; 2017. p. 199–215.
Lodish HF, editor. Molecular Cell Biology (4th ed). New York: W.H. Freeman; 2000. p. 1084.
George N, Geller HM. Extracellular matrix and traumatic brain injury. J Neuro Res. 2018;96(4):573–88.
Budiarsa IK, Susilawathi NM, Yaputra F, Widyadharma IPE. Sawar otak. Call Neuro J. 2019;2(1):14–8.
Agrawal A, Galwankar S, Kapil V, Coronado V, Basavaraju SV, McGuire LC, et al. Epidemiology and clinical characteristics of traumatic brain injuries in a rural setting in Maharashtra, India. Int J Crit Illn Inj Sci. 2012;2(30;167-71. Doi: 10.4103/2229-5151.100915
Matoha J, Prasetyo E, Oley MC. Hubungan antara skala skor FOUR dan CT Marshall dengan penilaian GCS pada penderita cedera otak akibat trauma Jurnal Biomedik (JBM). 2016;8(3):192-6.
Sudarsono F, Prasetyo E, Oley MC, Langi FLFG. Hubungan kadar laminin serum dengan klasifikasi CT Marshall dan GCS pada pasien cedera otak akibat trauma. e-CliniC. 2021;9(1):238-42.
Kurniawan MO, Prasetyo E, Oley MC. Hubungan kadar interleukin 10 serum dan klasifikasi CT Marshall pada pasien cedera otak berat akibat trauma, Jurnal Biomedik (JBM). 2019;11(2):97-103.
Tri AA, Sudjito MH. Kerusakan barier pertahanan alamiah: sawar darah otak. JNI. 2015;4(1):50–60.
Zhao Q-J, Zhang X-G, Wang L-X. Mild hypothermia therapy reduces blood glucose and lactate and improves neurologic outcomes in patients with severe traumatic brain injury. J Crit Care. 2011; 26(3):311–5.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Diornald J. Mogi, Eko Prasetyo, Maximillian Ch. Oley, Ferdinan Tjungkagi, Yovanka N. Manuhutu
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
COPYRIGHT
Authors who publish with this journal agree to the following terms:
Authors hold their copyright and grant this journal the privilege of first publication, with the work simultaneously licensed under a Creative Commons Attribution License that permits others to impart the work with an acknowledgment of the work's origin and initial publication by this journal.
Authors can enter into separate or additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (for example, post it to an institutional repository or publish it in a book), with an acknowledgment of its underlying publication in this journal.
Authors are permitted and encouraged to post their work online (for example, in institutional repositories or on their website) as it can lead to productive exchanges, as well as earlier and greater citation of the published work (See The Effect of Open Access).
