Hubungan Derajat Skor CURB-65 Saat Awal Masuk dan Nilai Antitrombin III pada Pasien Pneumonia Komunitas

Abstract

Pada penderita pneumonia komunitas (PK) dilakukan penilaian derajat keparahan pada awal pasien masuk sangat penting sebab akan menentukan beratnya penyakit dan rencana tata laksana selanjutnya. Antitrombin III (AT-III) sebagai biomarker koagulasi berguna untuk menilai tingkat keparahan PK pada saat awal masuk. AT-III dapat berperan dalam diagnosis, memutuskan pemberian antibiotik, dan prognosis penderita PK. Penelitian ini betujuan mengetahui hubungan skor confusion, urea, respiratory rate, blood pressure, age >65 years (CURB-65) dan nilai AT-III pada saat awal pasien PK datang ke rumah sakit. Desain penelitian adalah potong lintang. Penelitian dilakukan di Rumah Sakit H. Adam Malik Medan pada bulan Februari–Maret 2013. Subjek dengan PK yang masuk dari instalasi gawat darurat, pasien rawat jalan setelah memenuhi kriteria dilakukan penilaian skor CURB-65, laboratorium darah, serta kultur sputum dan darah. Selanjutnya, skor CURB-65 dihubungkan dengan AT-III dan parameter lainnya. Sebanyak 55 subjek penelitian yang tergolong dalam skor CURB-65 berat (3–5) sebanyak 23 orang (42%), skor sedang (2) sebanyak 17 orang (31%) dan skor ringan (0–1) sebanyak 15 orang (27%). Setelah dilakukan uji korelasi Spearman diperoleh hubungan signifikan antara derajat skor CURB-65 dan nilai AT-III (p= 0,0001). Simpulan, AT-III merupakan biomarker koagulasi yang memiliki hubungan dengan derajat keparahan PK yang dinilai dengan skor CURB-65 sehingga AT-III dapat digunakan untuk menentukan prognosis pasien PK sejak awal masuk rumah sakit. [MKB. 2016;48(2):92–8]

Kata kunci: Antitrombin III (AT-III), pneumonia komunitas (PK), prognosis, skor CURB-65

Correlation between CURB-65 and Antithrombin III Scores in Community Acquired Pneumonia at Early Admission in Hospital


The assessment of the level of severity in patients with community acquired pneumonia (CAP) is very important to determine the next steps in the disease management. Antithrombin III (AT-III) is known as one of the coagulation biomarkers that may be useful for predicting the severity of CAP at early admission in hospital. The AT-III is known to be used in diagnosis to help clinicians decide the antibiotic treatment to be given and to make prognosis. The aim of this cross-sectional study was to determine the correlation between confusion, urea, respiratory rate, blood pressure, age >65 years (CURB-65) score and AT-III in CAP patients at early admission in hospital. The method of study . The data were collected in Adam Malik Hospital from February to March 2013. CAP subjects were examined with CURB-65 score, AT-III, other laboratory assessments, sputum, and blood cultures at the early admission in the emergency room and outpatient clinic. The CURB-65 score was correlated with AT-III to determine the prognostic use of AT-III. A total of CAP 55 subjects  were assessed with 23 subjects (42%) with  severe CURB-65 scores (3–5), 17 subjects (31%) with moderate scores (2) , and15 subjects (27%) with mild scores (0–1). A significant correlation between CURB-65 and AT-III was found through the use of Spearman correlation test (p=0.0001). In conclusion, AT-III is a coagulation biomarker that correlates with the CURB-65 clinical scoring system. AT-III can be used to determine the prognosis in CAP at early admission in hospital. [MKB. 2016;48(2):92–8]

Key words: Antithrombin III (AT-III), community acquired pneumonia (CAP), CURB-6 score,  prognosis

DOI: 10.15395/mkb.v48n2.762