Research Article

Hubungan nilai Red Cell Distribution Width (RDW) dengan tingkat keparahan pneumonia pada pasien anak di RSUD Wangaya Denpasar, Bali-Indonesia

Made Cynthia Mahardika Putri , I Wayan Bikin Suryawan, I Kadek Suarca

Made Cynthia Mahardika Putri
Fakultas Kedokteran dan Ilmu Kesehatan, Universitas Warmadewa, Denpasar, Bali, Indonesia. Email: cynthiamahardika@gmail.com

I Wayan Bikin Suryawan
Bagian Ilmu Kesehatan Anak Rumah Sakit Umum Daerah Wangaya, Denpasar, Bali, Indonesia

I Kadek Suarca
Bagian Ilmu Kesehatan Anak Rumah Sakit Umum Daerah Wangaya, Denpasar, Bali, Indonesia
Online First: October 21, 2021 | Cite this Article
Mahardika Putri, M., Suryawan, I., Suarca, I. 2021. Hubungan nilai Red Cell Distribution Width (RDW) dengan tingkat keparahan pneumonia pada pasien anak di RSUD Wangaya Denpasar, Bali-Indonesia. Intisari Sains Medis 12(3): 757-762. DOI:10.15562/ism.v12i3.1133


Latar Belakang: Pneumonia merupakan penyebab kematian tertinggi pada anak usia kurang dari lima tahun. Berdasarkan Profil Kesehatan Indonesia 2019 terdapat 52,7% kasus pneumonia anak di Indoneisa. Tingginya kasus kematian akibat pneumonia pada anak menandakan beratnya gejala yang timbul dan perburukan klinis yang terjadi, sehingga penting untuk menemukan penanda yang dapat memprediksi anak yang cenderung akan mengalami perburukan klinis. Red cell distribution width (RDW) adalah suatu penanda pada pemeriksaan darah standar namun klinisnya jarang diperhatikan. Tujuan penelitian ini adalah untuk mengetahui hubungan nilai RDW dengan tingkat keparahan pneumonia pada pasien anak.

Metode: Jenis penelitian yang digunakan adalah studi analitik observasional dengan pendekatan cross-sectional. Pengambilan sampel menggunakan metode consecutive sampling. Data yang diperoleh dianalisis secara analitik, menggunakan program computer SPSS versi 25.0 dengan uji chi square dan uji independent t-test.

Hasil: Rerata RDW didapatkan lebih tinggi pada kelompok subjek dengan pneumonia berat (15,48 ± 1,95) dibandingkan kelompok dengan pneumonia ringan (13,73 ± 1,11) (p=0,000).

Simpulan: Terdapat hubungan bermakna antara RDW dengan tingkat keparahan pneumonia. 

 

 

Background: Pneumonia is the highest cause of death in children less than five years old. Based on the 2019 Indonesian Health Profile, there were 52.7% cases of childhood pneumonia in Indonesia. The high number of deaths from pneumonia in children indicates the severity of the symptoms and the clinical deterioration that occurs, so it is essential to find markers that can predict children who are likely to experience clinical deterioration. Red cell distribution width (RDW) is a marker on standard blood tests but is rarely seen clinically. This study aimed to determine the relationship between the RDW value and the severity of pneumonia in pediatric patients.

Methods: The type of research used is an observational analytic study with a cross-sectional approach. Sampling used the consecutive sampling method. The data obtained were analyzed analytically, using the computer program SPSS version 25.0 with chi-square test and independent t-test.

Results: The mean RDW was higher in person with severe pneumonia (15.48 ± 1.95) than the group with mild pneumonia (13.73 ± 1.11) (p=0.000).

Conclusion: There is a significant relationship between RDW and the severity of pneumonia.

References

Mahalastri NND. The Correlation Between Indoor Air Pollution with the Incident of Toddler’s Pneumonia. J Berk Epidemiol. 2014;2(3):392. Available from: http://dx.doi.org/10.20473/jbe.v2i32014.392-403

Oktaria V, Danchin M, Triasih R, Soenarto Y, Bines JE, Ponsonby AL, Clarke MW, Graham SM. The incidence of acute respiratory infection in Indonesian infants and association with vitamin D deficiency. PLoS One. 2021;16(3):e0248722. doi: 10.1371/journal.pone.0248722.

Kliegman RM. Nelson Textbook of Pediatrics. Elsevier; 2011. p. 1404-1405.e1. Available from: http://dx.doi.org/10.1016/b978-1-4377-0755-7.00351-1

Graham SM, English M, Hazir T, Enarson P, Duke T. Challenges to improving case management of childhood pneumonia at health facilities in resource-limited settings. Bull World Health Organ. 2008;86(5):349–55. Available from: https://pubmed.ncbi.nlm.nih.gov/18545737

Kaunang CT, Runtunuwu AL, Wahani AMI. Gambaran karakteristik pneumonia pada anak yang dirawat di ruang perawatan intensif anak RSUP Prof. Dr. R. D. Kandou Manado periode 2013 – 2015. e-CliniC. 2016;4(2). Available from: http://dx.doi.org/10.35790/ecl.4.2.2016.14399

Ryalino C, Budi Hartawan In, Saputra Y. Correlation of red cell distribution width value with the duration of mechanical ventilator usage in patients treated in pediatric intensive care unit. Bali J Anesthesiol. 2020;4(3):99. Available from: http://dx.doi.org/10.4103/bjoa.bjoa_27_20

Kristianto W, Setyoningrum RA, Boediono A. Red-Cell Distribution Width (RDW) dan Mean Platelet Volume (MPV) sebagai Biomarker Keparahan Pneumonia Anak. Sari Pediatr. 2018;19(6):335. Available from: http://dx.doi.org/10.14238/sp19.6.2018.335-41

Andriyani S, Keliat EN, Abidin A. Hubungan Derajat Skor CURB-65 Saat Awal Masuk dan Nilai Antitrombin III pada Pasien Pneumonia Komunitas. Maj Kedokt Bandung. 2016;48(2):92–8. Available from: http://dx.doi.org/10.15395/mkb.v48n2.762

Oktaria V, Triasih R, Graham SM, Bines JE, Soenarto Y, Clarke MW, Lauda M, Danchin M. Vitamin D deficiency and severity of pneumonia in Indonesian children. PLoS One. 2021;16(7):e0254488. Available from: doi: 10.1371/journal.pone.0254488. PMID: 34242372; PMCID: PMC8270442.

Nurjannah N, Sovira N, Anwar S. Profil Pneumonia pada Anak di RSUD Dr. Zainoel Abidin, Studi Retrospektif. Sari Pediatr. 2016;13(5):324. Available from: http://dx.doi.org/10.14238/sp13.5.2012.324-8

Lim WS. Pneumonia—Overview. Reference Module in Biomedical Sciences. 2020:B978-0-12-801238-3.11636-8. Available from: doi: 10.1016/B978-0-12-801238-3.11636-8.

Muenchhoff M, Goulder PJR. Sex differences in pediatric infectious diseases. J Infect Dis. 2014;209 Suppl 3(Suppl 3):S120–6. Available from: https://pubmed.ncbi.nlm.nih.gov/24966192

Artawan A, Purniti PS, Sidiartha IGL. Hubungan antara Status Nutrisi dengan Derajat Keparahan Pneumonia pada Pasien Anak di RSUP Sanglah. Sari Pediatr. 2016;17(6):418. Available from: http://dx.doi.org/10.14238/sp17.6.2016.418-22

Rizqullah N-, Putri M, Zulmansyah Z. Hubungan Status Imunisasi Dasar terhadap Pneumonia pada Pasien Balita Rawat Inap di RSIA Respati Tasikmalaya. J Integr Kesehat Sains. 2021;3(1):19–23. Available from: http://dx.doi.org/10.29313/jiks.v3i1.7296

Kurniawati S. Korelasi antara Status Gizi dengan Derajat Community Acquired Pneumonia (CAP) Pada Pasien Balita di RSUP Dr Sardjito Yogyakarta. Skripsi. FK Farmasi Universitas Sanata Dharma Yogyakarta; 2020.

Uwaezuoke SN, Ayuk AC. Prognostic scores and biomarkers for pediatric community-acquired pneumonia: how far have we come? Pediatr Heal Med Ther. 2017;8:9–18. Available from: https://pubmed.ncbi.nlm.nih.gov/29388605

Karakioulaki M, Stolz D. Biomarkers and clinical scoring systems in community-acquired pneumonia. Ann Thorac Med. 2019;14(3):165-172. Available from: doi: 10.4103/atm.ATM_305_18.

Shim JY, Shim JW, Kim DS, Jung HL, Park MS. Atopic Sensitization Increases Severity Of H1N1 Virus-Associated Lower Respiratory Tract Infection In Children [Internet]. C25. Pediatric Respiratory Infections. American Thoracic Society; 2011. Available from: http://dx.doi.org/10.1164/ajrccm-conference.2011.183.1_meetingabstracts.a4152

Miranda SJ. Validity of Red Cell Distribution Width as a Predictor of Clinical Outcomes in Pediatric Patients Diagnosed With Pneumonia. Chest. 2017;152(4):A843. Available from: http://dx.doi.org/10.1016/j.chest.2017.08.877

Farghly S, Abd-Elkader R, El Zohne RA, Abd El-Kareem DM. Mean platelet volume change (?MPV) and red blood cell distribution width (RDW) as promising markers of community-acquired pneumonia (CAP) outcome. Egypt J Bronchol. 2020;14(1). Available from: http://dx.doi.org/10.1186/s43168-020-00024-z

Braun E, Kheir J, Mashiach T, Naffaa M, Azzam ZS. Is elevated red cell distribution width a prognostic predictor in adult patients with community acquired pneumonia? BMC Infect Dis. 2014;14:129. Available from: https://pubmed.ncbi.nlm.nih.gov/24597687

Khanbabaee G, Hashemi SM, Salarian S, Fariborzi MR, Kiumarsi A. Red Cell Distribution Width Elevation and Sepsis in Pediatric Critically Ill Patients. Arch Pediatr Infect Dis. 2018;6(2). Available from: http://dx.doi.org/10.5812/pedinfect.12210

Mahmood N, Zaidi H, Patel V, Ali MI, Azam H, DeBari V, et al. Red Blood Cell Distribution Width As A Prognostic Indicator In Community-Acquired Pneumonia. A54. Assessing Severity Of Disease In Patients With Community Acquired Pneumonia. American Thoracic Society; 2012. Available from: http://dx.doi.org/10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a1804

Aostafa A, Haridi H, Ahmed M, Taghreed G.,Madani ME. Red Cell Distribution Width as a Marker of Inflammation in Type 2 Diabetes Mellitus. Med J Cairo Univ. 2018;86(9):2287–95. Available from: http://dx.doi.org/10.21608/mjcu.2018.57522

Handbook of Interventional Radiologic Procedures, 4th edKandarpaKrishna and MachanLindsay Philadelphia, Pa: Wolters Kluwer Lippincott Williams & Wilkins, 2011. Available from: http://dx.doi.org/10.1148/radiol.12124007

Allen LA, Felker GM, Mehra MR, Chiong JR, Dunlap SH, Ghali JK, et al. Validation and potential mechanisms of red cell distribution width as a prognostic marker in heart failure. J Card Fail. 2010;16(3):230–8. Available from: https://pubmed.ncbi.nlm.nih.gov/20206898


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