BEBERAPA FAKTOR RISIKO YANG MEMPENGARUHI KEJAIMAN STROKE BERULANG (Studi Kasus di RS Dr. Kariadi Semarang)

Abstract

Background : Stroke is the third ranking cause of death, with an overall mortality rate of 18 — 37% for the first stroke and of 62% for subsequent stroke. The incidence for recurrent stroke was different, it was approximately 25% people survive from stroke and it will become recurrent stroke for 5 years later. Recurrent stroke related to their own risk factors, especially if they are not treated well. The purpose of this research is to obtain risk factors that related to recurrent stroke. Method : Case control study. The case were patients treated in Dr. Kariadi hospital with recurrent stroke based on their health history, the neurological examination and Head CT scan examination that administered from June to July 2004, while control was that the patients suffered from first stroke. The sample of case and control were 50 patients each, it was taken by consequtive sampling. Result : Risk factors were independently related to recurrent stroke were systolic blood pressure, diastolic blood pressure, a pointed blood glucose level, the blood glucose level 2 hours post-prandial, heart diseases, and regularility treatment. Multivariate analysis showed that risk factors related to recurrent stroke : systolic blood pressure > 140 mmHg (OR = 7,04; 95% CI = 2,101 — 23,628), a pointed blood glucose level > 200 mg/dl (OR = 5,56; 95% CI = 1,437 — 21,546), heart diseases (OR = 4,62; 95% CI = 1,239 — 17,295), and irregularility treatment (OR = 4,39; 95% CI = 1,623 — 11,886). Conclusion : There were four risk factors related to recurrent stroke, i.e systolic blood pressure > 140 mmHg, a pointed blood glucose level > 200 mg/dl, abnormality heart, and irregularly treatment. Suggestion : participate the treatment program regularly and giving information of risk factors of the recurrent stroke and its management. Latar Belakang : Stroke merupakan penyebab ketnatian terbesar ketiga dengan laju mortalitas 18-37% untuk stroke pertama, dan 62% untuk stroke bend ang. Insiden stroke berulang berbeda-beda, diperkirakan 25% orang yang sembub dari stroke pertama akan mendapatkan stroke berulang dalam kurun waktu 5 tahun. Terjadinya stroke berulang berkaitan dengan faktor risiko yang dipunyai oleh penderita, terutama bila faktor risiko yang ada tidak ditanggulangi dengan baik. Tujuan penelitian ini adalah untuk mengetahui faktor-faktor risiko yang berhubungan dengan kejadian stroke berulang. Metode : Rancangan penelitian kasus kontrol. Kasus adalab penderita yang berobat di RS Dr. Kariadi Semarang yang didiagnosis sebagai stroke berulang berdasarkan riwayat penyakit, perneriksaan neeurologi dan perneriksaan Head CT Scan yang tercatat dalam rekam medis, periode Juni-Juli 2004, sedangkan kontrol adalah penderita stroke yang didiagnosis belurn/tidak mengalami stroke berulang. Jumlah kasus dan kontrol masing-masing 50 orang , diambil secara consecutive sampling. Analisis data dengan X2 untuk uji bivariat dan regresi ganda logistik untuk uji multivariat. 'Iasi! • Faktor risiko yang secara mandiri berhubungan adalah tekanan darah sistolik, tekanan darah diastolik, kadar gula darah sewaktu, kadar gula darah 2 jam post-prandial, kelainan jantung, dan keteraturan berobat. Analisis multivariat menunjukkan bahwa faktor risiko yang berpengaruh terhadap kejadian stroke berulang adalah tekanan darah sistolik 140 mmHg (OR = 7,04; 95% CI = 2,101 — 23,628), kadar gula darah sewaktu > 200 mg/d1 (OR = 5,56; 95% CI = 1,437 — 21,546) kelainan jantung (OR = 4,62; 95% CI = 1,239 — 17,295), dan ketidak teraturan berobat (OR = 4,39; 95% CI = 1,623 — 11,886). Simpulan : Terdapat 4 faktor risiko yang berpengaruh terhadap kejadian stroke berulang yaitu tekanan darah sistolik 140 mmHg, kadar gula darah sewaktu > 200 rng/dl, kelainan jantung, dan ketidak teraturan berobat. Saran : Perlu dilakukan pengobatan secara rutin, dan pemberian informasi tentang faktor risiko stroke berulang serta cara pengandaliannya.