Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Analisis Nilai Functional Independence Measure Penderita Cedera Servikal Dengan Perawatan Konservatif

Cedera servikal merupakan salah satu cedera tulang belakang terbanyak pada pasien trauma. Di Amerika Serikat tahun 2008 dari 100.000 kasus cedera tulang belakang, sebanyak 67% merupakan kasus cedera servikal. Penilaian awal dilakukan berdasarkan American Spinal Cord Injury Association (ASIA) impairment score namun prognosis outcome sering tidak diperhatikan. Tujuan penelitian untuk menganalisis nilai functional independence measure (FIM) pasien cedera servikal dengan manajemen konservatif dan korelasi dengan umur, jenis kelamin, jenis trauma, onset trauma, abnormalitas servikal, jenis lesi cervical spine, dan ASIA impairment score. Dilakukan studi kohor prospektif pada semua pasien cedera servikal yang memenuhi kriteria inklusi di bagian Bedah Saraf Rumah Sakit (RS) Dr. Hasan Sadikin Bandung. Subjek dikelompokkan berdasarkan umur, jenis kelamin, trauma tunggal/multipel, akut/kronik, abnormalitas servikal, lesi komplit/inkomplit dan ASIA impairment score. Pemeriksaan nilai FIM dilakukan di Poliklinik Bedah Saraf. Data dianalisis menggunakan uji t dan uji chi-kuadrat. Terdapat 17 pasien cedera servikal yang dirawat di bagian Bedah Saraf RS Dr. Hasan Sadikin Bandung periode April 2009–April 2010. Observasi kohor prospektif rata-rata nilai FIM pasien cedera servikal adalah 4±1,63. Analisis chi-kuadrat menyebutkan bahwa tidak terdapat hubungan umur, jenis kelamin, jenis trauma, onset trauma, abnormalitas servikal dengan besarnya nilai FIM pasien cedera servikal. Terdapat hubungan jenis lesi cervical spine, ASIA impairment score dengan besarnya nilai FIM pasien cedera servikal. Jenis lesi cervical spine dan ASIA impairment score memiliki hubungan bermakna dengan besarnya nilai FIM pasien 6 bulan pascacedera servikal.

Cervical spine injury is one of the most common spinal cord injuries in trauma patients. From 100,000 spinal cord injury cases reported in the United States of America (2008), sixty seven percent involve cervical spine injury. American Spinal Cord Injury Association (ASIA) impairment score is used as an initial assessment but not enough attention prognostic outcome of these patients was paid to. The objective of this study is to analyze the value of functional independence measure (FIM) cervical spine injury patients with conservative management and its correlation with age, sex, type of trauma, onset of trauma, cervical abnormalities, type of cervical spine lesion and ASIA impairment score. A prospective cohort study was performed to all patients with cervical spine injury treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital Bandung that fullfiled the inclusion criteria. The subjects were classified based on age, sex, single/multiple trauma, acute/chronic, cervical abnormalities, complete/incomplete lesion and ASIA impairment score. The FIM examination was performed in Outpatient clinic of Neurosurgery. T-test and chisquare test was done to analyze the data. There were 17 cervical spine injury patients treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital during April 2009–April 2010. The average FIM value of cervical spine injury in those patients is 4+1.63 by cohort prospective study. There were no correlation between FIM value with age, sex, type of trauma, onset of trauma and cervical abnormalities. Significant correlations were found between FIM value with type of cervical spine lesion and ASIA impairment score in cervical spine patients. Type of cervical spine lesion and ASIA impairment score have significant correlation with FIM value of patients in 6 months after cervical injury.