PENURUNAN JUMLAH TROMBOSIT SEBAGAI FAKTOR RISIKO TERJADINYA PERDARAHAN PADA PASIEN DEMAM BERDARAH DENGUE DEWASA DI RSUP Dr. KARIADI SEMARANG

Abstract

Background: Bleeding manifestation is caused by 3 components. Blood vessels factor, coagulation factor and thrombocyte. Thrombocytopenia causes bleeding. But in Dengue Hemorrhagic Fever ( DHF ) patients with thrombocytopenia do not always develop bleeding manifestation. Objective: To know whether decreasing of thrombocyte count increases the risk of bleeding manifestation in DHF patients. Method: This study was retrospective analytic observational study. The data were secondary data from DHF patients medical record between 1 July 2001 – 30 June 2006. The thrombocyte data used were thrombocyte count in case of bleeding manifestation occurred or the lowest thrombocyte count in case of no bleeding manifestation. ROC analysis was done to determine the cut off point. Chi Quadrat was used. The data were then proccesed with SPSS 15 For Windows. Result: ROC analysis showed the optimum cut off point for bleeding was 88.820. Out of 341 adult DHF patients samples, 190 patients had thrombocyte count ≤ 88.820 / mm3 and 151 patients had thrombocyte count > 88.820 / mm3. Out of 190 patients with thrombocyte count ≤ 88.820 / mm3, 10 patients developed severe bleeding manifestation and the remaining 180 did not ( they only developed mild bleeding manifestation or did not developed them at all ). Out of 151 patients with thrombocyte count >88.820 / mm3, 2 patients developed severe bleeding manifestation and the remaining 149 did not. Fisher’s Exact Test showed the value of p was 0,05 and odds ratio for thrombocyte was 4,139. Conclusion: Decreasing of thrombocyte count < 88.820 / mm3 increases the risk of bleeding manifestation in DHF patients. Key words: Dengue Hemorrhagic Fever, thrombocytopenia, bleeding manifestation.