Korelasi antara Skor ICH C-Reactive Protein, D-Dimer terhadap Luaran Pasien Perdarahan Intraserebral

Rr Sinta Irina, Rr Suzy Indharty


Latar Belakang dan Tujuan: Perdarahan intraserebral (Intracerebral hemorrhage/ICH) merupakan 10% hingga 15% dari semua stroke dan memiliki angka mortalitas dan morbiditas yang tinggi di dunia. Skor ICH valid untuk memprediksi derajat keparahan pasien perdarahan intraserebral yang dirawat di ICU. Kenaikan nilai C-reactive protein (CRP) menjadi prediktor terhadap hasil luaran pasien ICU. Tujuan penelitian adalah untuk mengetahui korelasi skor ICH, CRP dan D-dimer terhadap hasil luaran pada pasien perdarahan intraserebral.
Subjek dan Metode: Subjek penelitian merupakan 27 orang pasien perdarahan intraserebral yang dirawat di ICU RSUP H. Adam Malik dan Rumah sakit Universitas Sumatera Utara. Pengambilan data secara consecutive sampling, kemudian diukur skor ICH, CRP, D-dimer dan dianalisa pemeriksaan tersebut dengan lama perawatan.
Hasil: Dari total 27 pasien, 22 (81,5%) pasien pindah ruang rawat dan 5 (18,5%) pasien meninggal dunia. Rerata untuk skor ICH 2,70(0,67), CRP 1,41(0,72), dan D-dimer 2757,96(1230,73). Hasil korelasi antara skor ICH dengan lama rawatan dijumpai korelasi positif (r = 0,498; p = 0,008), didapatkan korelasi lemah antara CRP dengan lama rawatan (r = 0,315; p = 0,109) dan korelasi antara D-dimer dengan lama rawatan dan dijumpai korelasi positif (r = 0,546; p = 0,003).
Simpulan: Didapati skor ICH, CRP dan D-dimer memiliki pengaruh terhadap lama rawatan pasien dengan perdarahan intraserebral


Correlation between ICH Score, C-Reactive Protein and D Dimer on the outcome of Intracerebral Hemorrhage Patients


Background and Objective: Intracerebral hemorrhage (ICH) accounts for 10% to 15% of all strokes and has a high mortality and morbidity rate in the world. The ICH score is valid for predicting the severity of intracerebral hemorrhage patients treated in the ICU. The increase in C-reactive protein (CRP) value is a predictor in the outcome of ICU patients. The aim of this study was to find out how the ICH, CRP and D-dimer scores correlated with the outcome in intracerebral hemorrhage patients.
Subjects and Methods: The subjects of this study were 27 patients with intracerebral hemorrhage who were treated in the ICU of H. Adam Malik Hospital and the University of North Sumatra Hospital. Data were collected using consecutive sampling, then ICH, CRP, D-dimer scores were measured and the examination was analyzed by length of stay.
Results: Out of a total of 27 patients, 22 (81.5%) patients moved to the ward and 5 (18.5%) patients died. The mean for ICH score was 2.70(0.67), CRP was 1.41(0.72), and D-dimer was 2757.96(1230.73). The results of the correlation between ICH score and length of stay found a positive correlation (r = 0.498; p = 0.008), a correlation between CRP and length of stay had a weak correlation (r = 0.315; p = 0.109) and a correlation between D-dimer and length of stay and found a correlation positive (r = 0.546; p = 0.003).
Conclusion: It was found that ICH, CRP and D-dimer scores had an effect on the length of stay of patients with intracerebral hemorrhage



Perdarahan intrakranial, skor ICH, C-reactive protein, D-dimer

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Rajashekar D, Liang J. Intracerebral Hemorrhage. StatPearls. 2023 [Internet]. 2023. Tersedia pada: https://www.ncbi.nlm.nih.gov/books/NBK553103/#article-23683.s8

An SJ, Kim TJ, Yoon BW. Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: An update. J Stroke. 2017;19(1): 3–10. https://doi.org/10.5853/jos.2016.00864

Kementerian Kesehatan Republik Indonesia. Kementerian Kesehatan Republik Indonesia. 2018. Retrieved May 2023, from https://kesmas.kemkes.go.id/assets/upload/dir_519d41d8cd98f00/files/Hasil-riskesdas-2018_1274.pdf

Rodríguez-Fernández S, Castillo-Lorente E, Guerrero-Lopez F, Rodríguez-Rubio D, Aguilar-Alonso E, Lafuente-Baraza J, et al. Validation of the ICH score in patients with spontaneous intracerebral haemorrhage admitted to the intensive care unit in Southern Spain. BMJ Open.2018; 8, 1–8. https://doi.org/10.1136/bmjopen-2018-021719.

Zhou Z, Liang Y, Zhang X, Xu J, Kang K, Qu H, Zhao M. Plasma D-dimer concentrations and risk of intracerebral hemorrhage: a systematic review and meta-analysis. Frontiers in Neurology. 2018; 9, 1114.

Buce-Satoba I, Rozkalne D, Mamaja B, Krumina G, & Ozolina A. Leukocytosis and C-Reactive protein may predict development of secondary cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage. Medicina. 2022; 58(2): 323.

Gülcher SS, Bruins NA, Kingma WP, Boerma EC. Elevated C-reactive protein levels at ICU discharge as a predictor of ICU outcome: a retrospective cohort study. Ann intensive care. 2016;6(1): 1–8.

Jackson G, Chari K. National hospital care survey demonstration projects: stroke inpatient hospitalizations. Natl Health Stat Report. 2019;(132):1–11.

Yu H, Huang Y, Chen X, Nie W, Wang Y, Jiao Y, et al. High-sensitivity C-reactive protein in stroke patients–The importance in consideration of influence of multiple factors in the predictability for disease severity and death. J Clin Neurosci. 2017; 36, 12–19.

Shoukat AR, Maruthi R. ICH score and basal plasma D-dimer in patients with intracerebral haemorrhage. J. Evolution Med. Dent. Sci. 2020; 9(10): 768–71. https://doi.org/10.14260/jemds/2020/167

Val Jordan E, Puertas AN, Pellejero JC, Lopez CR, Monsteirin NF, Goixart LS, Diaz MQ. Role of perioperative plasma D-dimer in intracerebral hemorrhage after brain tumor surgery: A prospective study. J Neurosci Neurol. Disord. 2022; 6, 024–031. https://doi.org/10.29328/journal.jnnd.1001064

Ryu JA, Bang OY, Lee GH. D-dimer levels and cerebral infarction in critically ill cancer patients. BMC Cancer. 2017; 17, 1–8. https://doi.org/10.1186/s12885-017-3588-7

Muresan EM, Golea A, Vesa SC, Givan I, Perju-Dumbrava L. Admission emergency department point-of-care biomarkers for prediction of early mortality in spontaneous intracerebral hemorrhage. In Vivo (Brooklyn). 2022; 36(3): 1534–43. https://doi.org/10.21873/invivo.12864

Subedi PP, Shilpakar SK. Correlation of D-Dimer level with outcome in traumatic brain injury. J. Soc. Surg. Nepal. 2014; 17(1): 21–30. https://doi.org/10.3126/jssn.v17i1.15177

Bernstein D, Coster D, Berliner S, Shapira, I, Zeltser D, Rogowski O, et al. C-reactive protein velocity discriminates between acute viral and bacterial infections in patients who present with relatively low CRP concentrations. BMC Infect Dis. 2021; 21(1): 1–7. 10. Doi: https://doi.org 1186/s12879-021-06878-y

Wiginton JG, Miulli DE, et al. inflammatory markers and severity of intracerebral hemorrhage. Cureus. 2018;10(10): e3529. Doi: https://doi.org/10.7759/cureus.3529

Laws L, Lee F, Kumar A, Dhar R. Admitting low-risk patients with intracerebral hemorrhage to a neurological step-down unit is safe, results in shorter length of stay, and reduces intensive care utilization: a retrospective controlled cohort study. Neurohospitalist. 2020; 10(4): 272–76. https://doi.org/10.1177/1941874420926760

Palabiyik O, Isik Y, Cegin MB, Goktas U, Kati I. efficiency of hematocrit, lymphocyte, c-reactive protein, dan transferrrin levels in predicting mortality in intensive care unit patients. Eur J Gen Med. 2015; 12(3): 222–226.

Wang D, Wang J, Li Z, Gu H, Yang K, Zhao X, et al. C-reaction protein and the severity of intracerebral hemorrhage: a study from chinese stroke center alliance. Neurol Res. 2022; 44(4): 285–90. https://doi.org/10.1080/01616412.2021.1980842

Bender M, Haferkorn K, Friedrich M, Uhl E, Stein M. Impact of early c-reactive protein/albumin ratio on intra-hospital mortality among patients with spontaneous intracerebral hemorrhage. J. Clin. Med. 2020; 9(4): 1236. https://doi.org/10.3390/ jcm9041236

DOI: https://doi.org/10.24244/jni.v12i2.541


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