Perbedaan Nilai The Clinic GBS Severity Evaluation Scale (CGSES) dan Skala Disabilitas Sindroma Guillain-Barre (SDSGB) pada Pasien Sindroma Guillian Barre dengan dan tanpa Imunoterapi

Abstract

Latar Belakang dan Tujuan: The Clinical GBS Severity Evaluation Scale (CGSES) dikembangkan untuk penentuan imunoterapi pasien Sindroma Guillian Barre (SGB) secara lebih obyektif. Skala Disabilitas SGB (SDSGB) menggambarkan tingkat keparahan SGB dan dapat digunakan menilai efektifitas pemberian imunoterapi. Tujuan penelitian untuk mengetahui perbedaan penilaian CGSES dan SDSGB pasien SGB dengan dan tanpa imunoterapi dan membandingkan kesesuaian keputusan subyektif dengan CGSES.
Subjek dan Metode: Penelitian observasional analitik potong lintang komparatif secara retrospektif pada pasien rawat SGB periode Januari 2015 – Maret 2020 di RSUP Dr Hasan Sadikin Bandung.
Hasil: Terdapat 92 subjek (35 dengan dan 57 tanpa imunoterapi). Rerata usia 41,5 tahun, dengan pria:wanita (57,6%:42,4%). Tidak didapatkan perbedaan demografi dan pemeriksaan fisik kedua kelompok, kecuali paresis saraf kranial (62,9% vs. 33,3%; p=0,006). Terdapat perbedaan rerata lama perawatan dengan dan tanpa imunoterapi (29,5±34,4 vs. 11,4±4,1 hari, p=0,0001). Hasil penilaian CGSES pasien SGB dengan dan tanpa imunoterapi memiliki perbedaan bermakna (p=0,035). Terdapat perbedaan signifikan SDSGB saat masuk dan pulang pasien dengan imunoterapi (p=0,007) dan tanpa imunoterapi (p=0,025). Terdapat ketidaksesuaian keputusan subyektif dengan nilai CGSES (nilai Kappa 0,117; CI95% 0,021-0,213)
Simpulan: Terdapat perbedaan skor CGSES dan SDSGB pada kelompok pasien SGB dengan dan tanpa imunoterapi. Terdapat ketidaksesuaian penilaian subyektif keputusan pemberian imunoterapi dengan skoring CGSES

Differences in Value of The Clinic GBS Severity Evaluation Scale (CGSES) and Guillain-Barre Syndrome Disability Scale (GBSDS) in Guillian Barre Syndrome (GBS) Patients with and without Immunotherapy

Abstract

Background and objective: The Clinical GBS Severity Evaluation Scale (CGSES) was developed to determine immunotherapy of GBS patients more objectively. GBS Disability Scale (SDSGB) describes severity of GBS and assesses effectiveness of immunotherapy. Purpose of this study was to measure difference of CGSES and GBSDS in GBS patients with and without immunotherapy and to compare the suitability of subjective decisions with CGSES.
Subject and Methods: This is a comparative cross-sectional analytic observational study retrospectively in GBS patients from January 2015-March 2020 hospitalized at Dr Hasan Sadikin Hospital, Bandung.
Results: There were 92 subjects (35 with and 57 without immunotherapy). Mean age was 41.5 years, and male:female ratio was 57.6%:42.4%. There were no differences in demographics and physical examination between two groups, except for cranial nerve paresis (62.9% vs. 33.3%; p=0.006). There was a difference in mean length of stay with and without immunotherapy (29.5 ± 34.4 vs. 11.4 ± 4.1 days, p=0.0001). Results of the CGSES assessment with and without immunotherapy had a significant difference (p=0.035). There were significant differences in GBSDS at admission and discharge with (p=0.007) and without immunotherapy (p=0.025). There was a discrepancy between subjective decisions and CGSES value (Kappa value 0.117; 95% CI 0.021-0.213).
Conclusion: There were differences in CGSES and GBSDS in group of GBS patients with and without immunotherapy. There was a discrepancy between subjective assessment of decision to give immunotherapy with CGSES scoring.