St. George’s Respiratory Questionnaire (SGRQ) sebagai Alat Bantu Diagnostik serta Prediktor Terjadinya Chronic Pulmonary Aspergillosis (CPA) pada Pasien Tuberkulosis Paru Pasca Terapi
DOI:
https://doi.org/10.35790/msj.v3i1.32890Abstract
Abstract: Patients of post therapy lung tuberculosis (TB) that still have permanent or worsened clinical signs might be caused by chronic pulmonary aspergillosis (CPA). Diagnosis of CPA is difficult to confirmed without complete supporting tests. This study was aimed to establish whether Saint George’s Respiratory Questionnaire (SGRQ) could be used as diagnostic tool and predictor of the occurence of CPA in post therapy lung TB patients. This was an analytical observational study with a cross sectional design. There were 72 patients who had negative Gene Xpert sputum; 34.7% with positive Aspergillus-specific IgG. Their clinical signs were evaluated with SGRQ. The results showed that there was a very significant relationship between clinical score and CPA (p<0.0001). The lower the clinical score the less the probability of CPA. In this analysis we determined the diagnosis value of clinical score with a probability cut-off point = 0.5 which led to clinical score cut-off point of 45.6 with further results, as follows: sensitivity 68.0%; specificity 95.7%; positive predictive value 89.5%; negative predictive value 84.9%; OR 47.8, and CI 95% (9,2-248,2). In conclusion, SGRQ could be used as diagnostic tool and predictor of the occurence of CPA in post therapy lung TB patients.
Keywords: post therapy lung TB; chronic pulmonary aspergillosis; Saint George’s Respiratory Questionnaire (SGRQ)
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Abstrak: Pasien TB paru pasca terapi yang masih memperlihatkan gejala klinis menetap atau bahkan memberat dapat disebabkkan oleh adanya chronic pulmonary aspergillosis (CPA). Diagnosis CPA sulit ditegakkan tanpa adanya pemeriksaan penunjang yang lengkap. Penelitian ini bertujuan untuk menentukan apakah Saint George’s Respiratory Questionnaire (SGRQ) dapat menjadi alat bantu diagnostik serta prediktor terjadinya CPA pada pasien TB paru pasca terapi. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Hasil penelitian mendapatkan 72 pasien dengan sputum Gene Xpert negatif (34,7% dengan positif IgG Aspergillus) dilakukan penilaian skor klinis menggunakan SGRQ. Hasil uji menunjukkan terdapat hubungan sangat bermakna antara skor klinis dengan terjadinya CPA (p<0,0001). Makin rendah skor klinis makin kecil peluang terjadinya CPA. Melalui analisis ini dapat ditentukan nilai diagnosis skor klinis SGRQ dengan mengambil titik potong peluang = 0,5. Nilai peluang = 0,5 memberikan titik potong skor klinis = 45,6. Dengan titik potong skor klinis SGRQ = 45,6 diperoleh nilai-nilai diagnosis sebagai berikut: Sensitivitas = 68,0%; Spesifisitas = 95,7%; Nilai Prediksi Positif = 89,5%; Nilai Prediksi Negatif = 84,9%; OR = 47,8 dengan CI 95% (9,2-248,2). Simpulan penelitian ini ialah SGRQ dapat menjadi alat bantu diagnostik serta prediktor terjadinya CPA pada pasien TB paru pasca terapi.
Kata kunci: tuberkulosis paru pasca terapi; chronic pulmonary aspergillosis; Saint George’s Respiratory Questionnaire (SGRQ)
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