Status Penggumpalan (Agregasi) Trombosit Sebagai Faktor Prognostik Tejadinya Keluaran Klinis Strok Infark Mendadak (Strok Infark Akut)

Abstract

The propriate management of acute infarction stroke will be able to reduce the morbidity and mortality of the disease. In diagnosingand managing the diseases, for the detection of the risk or prognostic factors information’s such as the history physical findings,confirmation and other supporting tests are needed. One of the supporting test is the laboratory examination i.e. platelet aggregationtest. Platelet aggregation is suggested having an important role in haemostasis especially to prevent excessive bleeding by forming plateletplug. Finally, further hyperactivity of platelet in terms of platelet hyper aggregation can create a thrombus and moreover lead to obstructthe vessels. The occlusion will give a negative outcome of an acute infarction stroke. The aim of this study is to know whether platelethyper aggregation has a contribution in the outcome of the disease or not by certain testing. A prospective cohort study was carried out,to compare between two groups of exposed and non-exposed group in Sardjito hospital Yogyakarta during the period of March up toearly July 2007. Eighty four subjects who met the inclusion and exclusion criteria were involved in this study. The exposed group was agroup of acute infarction stroke patient who were exposed to platelet hyper aggregation 48 (57%), on the other hand, patients who didnot have platelet hyper aggregation was separated as non-exposed group is 36 (43%). Inception of cohort was applied when the patientwas admitted to the emergency unit during 72 hours of the onset, before receiving antithrombotic drugs and had no previous history ofstroke. The patients were followed after 7 days hospitalization in the stroke unit and neurology unit and the outcome was measured byevaluating the score using Gadjah Mada stroke scale. The characteristics of the subjects were grouped by baseline data X2 test. Unvariedanalysis and multivariate analysis were taken to get the relative risk of having acute infarction stroke. In this case logistic regressionanalysis was used to know the relative risk (RR) measurement. Prognostic factors had influenced the outcome of acute infarction strokein patients who had a history of cardiovascular disease and aggregation status. The outcome of the platelet hyper aggregation grouphad a RR=2.15 (95% CI: 2.01–4.07) and the history of cardiovascular disease had a RR=1.78 (95% CI: 1.18–13.28).

Changes in Platelet Aggregation and Nihss After Anti-Platelet Therapy for Acute Ischemic Stroke Patients at H. Adam Malik General Hospital Medan

“…This research is relevant to the research Sembiring et al, (2017) which says education is the most research subjects senior high school (45%), followed by junior high school (35%) and the smallest is an undergraduate (8.3%). 17 It is slightly different from the study by Rosita et al (2011) that the highest level of education is primary school as many as 40 subjects (40%), but if we look at this research, it has the same thing that most of the subjects did not continue their education to university. 13 The employment status in this study is divided into two, namely working and not working.…”

“…17 It is slightly different from the study by Rosita et al (2011) that the highest level of education is primary school as many as 40 subjects (40%), but if we look at this research, it has the same thing that most of the subjects did not continue their education to university. 13 The employment status in this study is divided into two, namely working and not working. Most of the work status in this study was not working as many as 20 subjects (52.6%).…”

“…Descriptive analysis of the characteristics of the NIHSS score in this study used the median (minimum-maximum) value because the data were not normally distributed. Obtained the NIHSS score first day was 11.50 (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21), with the characteristic neurological deficits that most of the categories were as many as 19 subjects (50.0%). The NIHSS value on the seventh days was 6.50 (1 -17), with the most characteristic neurological deficits in the moderate category as many as 21 subjects (55.3%).…”

“…This is relevant to the research conducted by Rosita et al (2011) which found that the most occupational statuses were unemployed as many as 36 subjects (43%). 13 According Riskesdas in 2018 the prevalence of stroke was higher in people with the status of the economy is low is not working based diagnostic healthcare or symptoms as much (21.8%). 3 Respondent ethnicity is divided into Batak as many as 25 subjects (65.8%), Malay as many as 8 subjects (21.1%), Javanese as many as 4 subjects (10.5%) and Aceh as many as 1 subject (2.6%), so that It was concluded that most of the respondents with ischemic stroke in this study came from the Batak tribe.…”

“…The platelet aggregation value on the seventh days after giving anti-platelet therapy with the most aggregation characteristics was the normoaggregation category as many as 37 subjects (97.4%). This is relevant to a study conducted by Rosita et al (2011) who conducted a study to examine the value of platelet aggregation before administering anti-platelets. This study found that the highest aggregation was hyperaggregation of 48 subjects (57.14 %).…”