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Analisis Terhadap Faktor Risiko yang Berhubungan dengan Mortalitas Pasien Sindrom Guillain-Barré yang Dilakukan Plasmaferesis

1Fakultas Kedokteran, Universitas Padjajaran, Bandung, Indonesia

2Departemen Anestesi dan Terapi Intensif, Fakultas Kedokteran, Universitas Padjadjaran/RSUP dr. Hasan Sadikin Bandung, Indonesia

Received: 1 Aug 2023; Revised: 20 Oct 2023; Accepted: 31 Oct 2023; Available online: 30 Nov 2023; Published: 20 Nov 2023.

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Abstract

Latar Belakang: Sindrom Guillain-Barré (SGB) merupakan penyakit autoimun yang mengenai sistem saraf tepi yang banyak ditemukan di dunia. Penyakit ini memiliki manifestasi berupa kelemahan, arefleksia otot secara progresif dan dapat menyebabkan kelemahan pada otot-otot pernapasan. Hal ini menyebabkan penderita membutuhkan bantuan ventilasi mekanik. American Society for Apheresis (ASFA) menyatakan pengobatan lini pertama krisis sindrom Guillain-Barré (SGB) fase akut adalah dengan pemberian therapeutic plasma exchange/plasmaferesis. Therapeutic plasma exchange merupakan prosedur yang relatif aman dan sudah sering dilakukan di unit rawat intensif Rumah Sakit Hasan Sadikin (RSHS) Bandung.

Tujuan: Penelitian ini dilakukan untuk menganalisis faktor-faktor risiko yang berhubungan dengan mortalitas pasien SGB yang telah menjalani terapi plasmaferesis.

Metode: Penelitian ini merupakan penelitian analitik multivariat dengan desain kasus kontrol yang dilakukan pada 55 sampel pasien SGB yang mendapatkan terapi plasmaferesis di unit rawat intensif RSHS Bandung dan rumah sakit (RS) Bhayangkara Tingkat II Medan. Penelitian ini bersifat retrospektif dengan mengambil data dari rekam medis serta menyajikan karakteristik dasar subjek.

Hasil: Penelitian ini mendapatkan hasil bahwa diantara faktor-faktor risiko yaitu usia, komorbid, dan lama penggunaan ventilasi mekanik, yang paling berhubungan dengan mortalitas pasien SGB yang telah menjalani terapi plasmaferesis adalah faktor lamanya penggunaan ventilasi mekanik >14 hari.

Kesimpulan: Faktor risiko penggunaan mesin ventilasi mekanik berkepanjangan (>14 hari) berhubungan dengan tingginya kejadian mortalitas/kematian pada pasien SGB yang menjalani terapi di RSHS Bandung, maupun di RS Bhayangkara Tingkat II Medan.

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Keywords: faktor risiko; mortalitas; plasmaferesis; sindrom Guillain-Barré (SGB); ventilasi mekanik berkepanjangan

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