Perbandingan Mini Mental State Examination (MMSE) dan Clock Drawing Test (CDT) untuk Mendeteksi Disfungsi Kognitif pada Cedera Otak Traumatik Ringan dan Sedang

Wenny Oktivia, Iwan Fuadi

Abstract


Latar Belakang dan Tujuan: Disfungsi kognitif sering terjadi pada pasien cedera otak traumatik (COT). Gangguan neuropsikologik yang disebabkan oleh cedera otak traumatik ringan dan sedang berupa penurunan kecepatan memproses informasi, gangguan perhatian, orientasi, dan fungsi eksekutif. Pemeriksaan disfungsi kognitif yang sering digunakan adalah Mini Mental State Examination (MMSE). Saat ini sedang dicari pemeriksaan lain yang lebih mudah dilakukan dan memiliki sensitifitas dan spesifisitas yang lebih baik, yaitu dengan Clock Drawing Test (CDT). Penelitian ini bertujuan membandingkan MMSE dan CDT dalam mendeteksi disfungsi kognitif pada COT ringan dan sedang.
Subjek dan Metode: Penelitian menggunakan observasi analitik cross sectional, dilakukan di Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung pada bulan Januari hingga April 2018. Pasien dibagi menjadi kelompok COT ringan (n=16) dan sedang (n=16) yang masing-masing dilakukan pemeriksaan MMSE dan CDT.
Hasil: Dengan nilai cut-off MMSE 26,5 didapatkan sensitivitas 93,8% dan nilai spesifisitas 81,3%, sedangkan menggunakan nilai cut-off CDT 2,5 didapatkan sensitifitas dan spesifisitas CDT 100%.
Simpulan: CDT memiliki sensitivitas dan spesifisitas yang lebih baik untuk mendeteksi disfungsi kognitif pada COT ringan dan sedang.

 

Comparison of Mini Mental State Examination (MMSE) and Clock Drawing Test (CDT) on Detecting Cognitive Dysfunction on Mild and Moderate Traumatic Brain Injury

Abstract

Background and Objective: Cognitive dysfunction often found in Traumatic Brain Injury (TBI). TBI can triggers neurophysicological, such as slower information processing, attention deficit, orientation disturbance, and executive function. There are methods to evaluate cognitive dysfunction, but none are showing 100% sensitivity and specificity. The frequently used method is Mini Mental State Examination (MMSE). Currently, other examinations are being sought that are easier to do and have better sensitivity and specificity, namely the Clock Drawing Test (CDT). This study is aimed to compare MMSE and CDT to detect cognitive dysfunction in Mild and Moderate TBI.
Subject and Method: This study is using analytical observation and cross-sectional study design, it was held in Hasan Sadikin Hospital Bandung throughout January 2017 to April 2018. Subjects are divided into Mild TBI group (n=16) and Moderate TBI group (n=16), both groups were given MMSE and CDT.
Result: Using cut-off point 26,5 for MMSE the sensitivity and specificity are 93.8% and 81.3%, while CDT achieved 100% sensitivity and specificity.
Conclusion: CDT has a better sensitivity and specificity on detecting cognitive dysfunction in Mild and Moderate TBI.


Keywords


Cedera otak traumatik; Clock Drawing Test; disfungsi kognitif; Mini Mental State Examination; Clock Drawing Test; cognitive dysfunction; Mini Mental State Examination; traumatic brain injury

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References


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