Kadar Prokalsitonin dan Interleukin-6 sebagai Penanda Prognostik pada Pasien Pneumonia dengan Sepsis
DOI:
https://doi.org/10.21776/ub.jkb.2019.030.04.6Keywords:
Interleukin-6, mortalitas, pneumonia dengan sepsis, prokalsitonin, SOFA scoreAbstract
Pneumonia merupakan sepuluh besar kasus rawat inap dengan tingkat kematian 7,6%. Pneumonia dengan sepsis membutuhkan terapi suportif dan perawatan intensif karena tingkat kematian tinggi. Untuk memperbaiki kualitas perawatan dan hasil terapi yang lebih baik, perlu pengkajian dini diagnostik maupun prognostik. Prokalsitonin (PCT) dan Interleukin-6 (IL-6) merupakan penanda infeksi berat dan sepsis. Tujuan penelitian ini untuk menganalisa apakah PCT dan IL-6 dapat digunakan bersama-sama untuk menentukan prognosis pasien pneumonia dengan sepsis dalam hubungannya dengan status mortalitas pada hari ke-30. Penelitian kohort dilakukan pada Oktober 2018 dilakukan di Rumah Sakit Saiful Anwar, Malang, melibatkan 40 pasien pneumonia dengan sepsis tanpa diabetes, kanker, HIV dan kehamilan. Sequential Organ Failure Assesment (SOFA) score dihitung dan sampel darah diambil pada hari ke-0 dan ke-5 perawatan untuk mengukur kadar PCT dan IL-6. Status mortalitas pasien dilihat pada hari ke-30 sejak masuk rumah sakit. Dari 40 pasien, 23 pasien hidup (57,5%) dan 17 pasien meninggal (47,5%). Perbandingan antara kelompok hidup dan meninggal menunjukan perbedaan bermakna dan secara signifikan berhubungan dengan mortalitas pada SOFA score hari ke-5 (p<0,001; OR: 78,75, CI 95% (9,948-623,414)), kadar IL-6 hari ke-5 (p<0,05; OR: 9,208, CI 95% (2,146-39,521)) dan kadar PCT hari ke-5 (p<0,05; OR: 4,190, CI 95% (1,104-15,901)). Hasil uji regresi logistik, didapatkan bahwa IL-6 hari ke-5 dan SOFA score hari ke-5 dapat digunakan sebagai faktor prognostik mortalitas pasien pneumonia dengan sepsis hari ke-30, artinya SOFA score diatas 6 dan kadar IL-6 diatas 332pg/mL pada hari ke-5, merupakan faktor penting dari kematian pasien (AUC: 0,935).Downloads
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