Pengaruh Penambahan Vitamin D dalam Pengobatan Stroke Iskemik Akut pada Pasien dengan Hipovitaminosis D terhadap Hasil Klinis
DOI:
https://doi.org/10.35790/fkvq0003Keywords:
modified Rankin scale; National Institutes of Health Stroke scale; stroke iskemik akut; vitamin DAbstract
Abstract: Hypovitaminosis D has a high prevalence among patients with acute ischemic stroke (AIS) and has been associated with poorer clinical outcomes. This systematic review and meta-analysis aimed to evaluate the effectiveness of adding vitamin D supplementation during AIS treatment in patients with hypovitaminosis D on the modified Rankin Scale (mRS) and the National Institutes of Health Stroke Scale (NIHSS). Literature search was conducted across five databases and only randomized controlled trials (RCTs) were included. Meta-analysis was performed using mean difference (MD) and 95% confidence intervals (CI). Risk of bias was assessed using the Cochrane Risk of Bias Tool 2. Certainty of evidence was evaluated using the GRADE approach for non-null effects. Two RCTs for mRS and three RCTs for NIHSS were included. Three RCTs were judged to have a high risk of bias. Addition of vitamin D reduced mRS scores (MD = -0.86; 95% CI = -1.17 to -0.54; I2 = 0%; moderate certainty) and NIHSS scores (MD = -1.45; 95% CI = -2.01 to -0.90; I2 = 0%; moderate certainty). In conclusion, Addition of vitamin D during acute ischemic stroke treatment in patients with hypovitaminosis D may reduce mRS and NIHSS scores.
Keywords: modified Rankin scale; National Institutes of Health Stroke scale; acute ischemic stroke; vitamin D
Abstrak: Hipovitaminosis D mempunyai prevalensi yang tinggi pada pasien stroke iskemik akut (SIA) dan telah dikaitkan dengan luaran klinis yang lebih buruk. Tinjauan sistematis dan meta-analisis ini bertujuan untuk mengevaluasi efektivitas penambahan suplementasi vitamin D selama pengobatan SIA pada pasien dengan hipovitaminosis D terhadap modified Rankin Scale (mRS) dan National Institutes of Health Stroke Scale (NIHSS). Pencarian dilakukan pada lima basis data pada 24 Agustus 2025 dan hanya uji coba acak (RCT) diikutsertakan. Meta-analisis dilakukan dengan mean difference (MD) dan confidence interval (CI) 95%. Penilaian risiko bias dilakukan dengan Cochrane Risk of Bias Tool 2. Keyakinan bukti dievaluasi dengan metode GRADE untuk efek non-nol. Dua RCT untuk mRS dan tiga RCT untuk NIHSS memenuhi kriteria kelayakan. Tiga RCT dinilai mempunyai risiko bias tinggi. Penambahan vitamin D secara signifikan menurunkan skor mRS (MD = -0,86; 95% CI = -1,17 hingga -0,54; I2 = 0%; keyakinan sedang) dan skor NIHSS (MD = -1,45; 95% CI = -2,01 hingga -0,90; I2 = 0%; keyakinan sedang). Simpulan penelitian ini adalah pemberian vitamin D selama pengobatan SIA pada pasien dengan hipovitaminosis D dapat menurunkan skor mRS dan NIHSS.
Kata kunci: modified Rankin scale; National Institutes of Health Stroke scale; stroke iskemik akut; vitamin D
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