Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Functional Independence Measure Penderita Cedera Servikal

Cedera servikal merupakan salah satu cedera tulang belakang terbanyak pada penderita trauma. Di Amerika Serikat tahun 2008 dari 100.000 kasus cedera tulang belakang, 2/3 merupakan kasus cedera servikal. Penilaian awal dilakukan berdasarkan American Spinal Cord Injury Association (ASIA) Impairment Score, sedangkan hasil setelah penatalaksanaannya sering diabaikan untuk evaluasi keberhasilan ahli di rumah sakit. Tujuan penelitian untuk mengetahui nilai functional independence measure (FIM) penderita cedera servikal dengan manajemen konservatif dan korelasinya dengan usia, jenis kelamin, jenis trauma, onset trauma, abnormalitas tulang servikal, lesi cervical spine, dan ASIA Impairment Score. Dilakukan studi kohor prospektif pada semua pasien cedera servikal yang memenuhi kriteria inklusi di Departemen Bedah Saraf Rumah Sakit (RS) Dr. Hasan Sadikin Bandung. Subjek dikelompokkan berdasarkan usia, jenis kelamin, trauma tunggal/multipel, akut/kronik, abnormalitas tulang servikal, lesi komplet/inkomplet, ASIA Impairment Score, dan komplikasi awal cedera. Pada penderita dilakukan penilaian FIM di Poliklinik Bedah Saraf. Data dianalisis menggunakan uji-t dan uji chi-kuadrat dengan p<0,05. Terdapat 17 penderita cedera servikal yang dirawat di Departemen Bedah Saraf RS Dr. Hasan Sadikin Bandung periode April 2009–April 2010. Observasi kohor prospektif nilai FIM rata-rata penderita cedera servikal adalah 4+1,63. Analisis chi-kuadrat menyatakan bahwa tidak terdapat hubungan usia (p=0,064), jenis kelamin (p=0,144), jenis trauma penyerta (p=0,959), onset cedera (p=0,220), abnormalitas tulang servikal (p=0,869) dengan besarnya nilai FIM pasien cedera servikal. Terdapat hubungan jenis lesi cervical spine (p=0,037), ASIA Impairment Score (p<0,001) dengan besarnya nilai FIM penderita cedera servikal. Simpulan, jenis lesi cervical spine dan ASIA Impairment Score memiliki hubungan bermakna dengan besarnya nilai FIM penderita 3 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), 2/3 involved cervical spine injury. American Spinal Cord Injury Association (ASIA) Impairment Score is used as an initial assessment but further prognostic outcome of these patients is often not paid enough attention. The objective of this study was to find the value of functional independence measure (FIM) cervical spine injury patients with conservative management and correlation with age, sex, type of trauma, onset of trauma, cervical bone abnormalities, type of spinal lesion and ASIA Impairment Score. A prospective cohort study was performed to all patients with cervical spine injury which fullfil the inclusion criteria treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital Bandung. The subjects were classified based on age, sex, single/multiple trauma, acute/chronic, cervical bone abnormalities, complete/incomplete lesion, ASIA impairment score and initial complication. The patients were performed to FIM examination in Outpatient clinic of Neurosurgery. T-test and chi-square test with p<0.05 were done to analyze the data. There were 17 cervical spine injury patients treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital Bandung during April 2009–April 2010. The average FIM value of cervical spine injury in those patients was 4+1.63 by cohort prospective study. There were no correlation between FIM value with age (p=0.064), sex (p=0.144), type of trauma (p=0.959), onset of trauma (p=0.220) and cervical bone abnormalities (p=0.869). We found a significant correlation between FIM value with type of cervical spine lesion (p=0.037) and ASIA Impairment Score (p<0.001) in cervical spine patients. In conclusion, type of cervical spine lesion and ASIA impairment score have significant correlation with FIM value of patients in 3 months after cervical injury.