Karakteristik Klinis dan Status Nutrisi pada Pasien Stroke Fase Akut

Abstract

Latar Belakang dan Tujuan: Disabilitas yang berat pada stroke meningkatkan risiko terjadinya malnutrisi. Malnutrisi pada pasien stroke dapat disebabkan oleh defisit neurologis dan faktor risiko. Malnutrisi pada stroke meningkatkan morbiditas dan mortalitas. Penelitian ini bertujuan untuk mengetahui karakteristik klinis dan status nutrisi pasien stroke.

Subjek dan Metode: Penelitian bersifat deskriptif retrospektif pada pasien stroke yang dirawat di RSUP Hasan Sadikin Bandung pada periode 1 Agustus 2020 hingga 30 September 2020. Status nutrisi dinilai menggunakan Indeks Massa Tubuh (IMT) dan skor Subjective Global Assessment (SGA). IMT dihitung menggunakan kg/m2, dikelompokkan menjadi obesitas (IMT >30), overweight (IMT 25,0–29,9), normal (IMT 18,5–24,9) dan underweight (IMT <18,5). Skor SGA <2 termasuk nutrisi baik, dan ≥2 tergolong malnutrisi.

Hasil: Didapatkan 52 orang pasien stroke yang sebagian besar berjenis kelamin laki-laki (57,7%) dengan rentang usia 38–86 tahun (rata-rata 57 tahun), 51,9% mengalami malnutrisi berdasarkan skor SGA, IMT normal dan overweight sebanyak 23 (44,2%) orang, diikuti obesitas (5,7%) dan underweight (5,7%). Ditemukan 71,4% usia ≥65 tahun mengalami malnutrisi. Kondisi malnutrisi didominasi pasien stroke infark kardioemboli (63,6%), dengan derajat stroke berat (58,3%), disfagia (59,4%), dengan komorbid infeksi (71,4%) dan stress ulcer (55,6%).

Simpulan: Berdasarkan penelitian ini, didapatkan bahwa usia tua , derajat stroke sedang-berat, komorbid infeksi dan stress ulcer akan memiliki kecenderungan malnutrisi sehingga penanganan stroke yang baik dapat menurunkan risiko terjadinya malnutrisi. Kejadian stroke berulang tidak menjadi risiko terjadinya malnutrisi pada penelitian ini.

 Clinical Characteristics and Nutrition Status in Acute Stroke Patients

 Abstract

Background and Objective: Severe disability in stroke increase the risk of malnutrition. Malnutrition in stroke patients can be caused by neurological deficits and risk factors. Malnutrition in stroke increases morbidity and mortality. This study aims to determine the clinical characteristics and nutritional status of stroke patients.

Subject and Methods: This study was a retrospective descriptive study of stroke patients who were treated in the Neurology ward of Hasan Sadikin Hospital Bandung from 1 August 2020 to 30 September 2020. Nutritional status was assessed using Body Mass Index (BMI) and Subjective Global Assessment (SGA) scores. BMI was calculated using kg/m2, grouped into obese (BMI> 30), overweight (BMI 25.0-29.9), normal (BMI 18.5-24.9) and underweight (BMI <18.5). SGA score <2 is considered as good nutrition, and ≥2 is classified as malnutrition.

Results: There were 52 stroke patients, most of them were male (57.7%) with an age range of 38-86 years old (mean 57 years), 51.9% were malnourished based on the SGA score, normal BMI and overweight were 23 (44.2%) people, followed by obesity (5.7%) and underweight (5.7%). We also found 71.4% aged ≥65 years are malnourished. This condition was dominated by cardioembolic stroke patients (63.6%), with severe stroke (58.3%), dysphagia (59.4%), with comorbid infections (71.4%) and stress ulcers (55.6%).

Conclusion: Based on this study, it was found that elderly, moderate-severe stroke, comorbid infections and stress ulcers have a tendency related to malnutrition. Good or better management can/indeed reduce the risk of malnutrition.  Stroke history was not a risk for malnutrition in this study.