Hubungan kadar Laju Endap Darah (LED) dan C-Reactive Protein (CRP) sebagai nilai prediktor dalam diagnosis osteomielitis dengan infeksi kaki pasien Diabetes Mellitus Tipe-2 (DM2) di RSUP DR. Wahidin Sudirohusodo, Makassar, Indonesia

Mulawardi; Jancung; Muhammad Nasser Mustari; Joko Hendarto

doi:10.15562/ism.v13i2.1433

Hubungan kadar Laju Endap Darah (LED) dan C-Reactive Protein (CRP) sebagai nilai prediktor dalam diagnosis osteomielitis dengan infeksi kaki pasien Diabetes Mellitus Tipe-2 (DM2) di RSUP DR. Wahidin Sudirohusodo, Makassar, Indonesia

Mulawardi ,

Jancung ,

Muhammad Nasser Mustari ,

Joko Hendarto ,

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DOI: https://doi.org/10.15562/ism.v13i2.1433 |
Published: 2022-08-23

Abstract

Background: Diabetes Mellitus Type-2 (DM2) is a disease that can cause various complications, one of the common complications is diabetic foot, especially in osteomyelitis patients. Several parameters are known to contribute to the occurrence of diabetic foot such as ESR and C-Reactive Protein (CRP). This study aims to evaluate the relationship between ESR and CRP levels as a predictor value in the diagnosis of osteomyelitis with foot infection in DM2 patients.

Methods: This study is a diagnostic study with cross-sectional data collection techniques on 67 patient medical records from the Department of Surgery, Dr. RSUP. Wahidin Sudirohusodho consecutively during the period from June to October 2020. The variables assessed in this study included age, gender, Body Mass Index (BMI), comorbidities, duration of diabetes, HbA1c, ESR, C-Reactive Protein (CRP), and osteomyelitis. Data were analyzed with SPSS version 20 for Windows.

Results: There was a significant difference in ESR levels (96.00 (79.00-115.00) vs. 67.50 (22.00-88.00 mm/hour; p=0.000), procalcitonin (16.04 (0.05) -42.03 vs. 30.17 (0.21-56.08) ng/mL; p=0.003), and female gender (72.00% vs. 28.00%; p=0.022) in both the osteomyelitis group and non-osteomyelitis. From the ROC curve analysis, the parameters with significant results were ESR (Cut-Off: 83.75 mm/hour; p=0.000) and procalcitonin (Cut-Off: 19.72 ng/mL; p=0.003) in the diagnosis of osteomyelitis in DM2 patients.

Conclusion: There is a significant difference in terms of ESR values and procalcitonin levels between the group of T2DM patients with osteomyelitis and without osteomyelitis. Of the three inflammatory marker parameters, namely CRP, ESR and procalcitonin, the ESR value is known to have the highest accuracy as a predictor of osteomyelitis.

Latar Belakang: Diabetes Mellitus Tipe-2 (DM2) merupakan penyakit yang dapat menimbulkan berbagai macam komplikasi, salah satu komplikasi yang umum terjadi adalah kaki diabetes khususnya pada pasien osteomielitis. Beberapa parameter diketahui berkontribusi terhadap terjadinya kaki diabetes seperti Laju Endap Darah (LED) maupun C-Reactive Protein (CRP). Penelitian ini bertujuan untuk mengevaluasi hubungan kadar LED dan CRP sebagai nilai prediktor dalam diagnosis osteomielitis dengan infeksi kaki pasien DM2

Metode: Penelitian ini merupakan penelitian diagnostik dengan teknik pengambilan data potong lintang terhadap 67 rekam medis pasien dari Departemen Ilmu Bedah RSUP Dr. Wahidin Sudirohusodho secara konsekutif selama periode Juni hingga Oktober 2020. Variabel yang dinilai pada penelitian ini meliputi usia, jenis kelamin, Indeks Massa Tubuh (IMT), komorbiditas, durasi menderita diabetes, HbA1c, Laju Endap Darah (LED), C-Reaktif Protein (CRP), dan osteomielitis. Data dianalisis dengan SPSS versi 20 untuk Windows.

Hasil: Terdapat perbedaan bermakna kadar LED (96,00 (79,00-115,00) vs 67,50 (22,00-88,00 mm/jam; p=0,000), prokalsitonin (16,04 (0,05-42,03 vs 30,17 (0,21-56,08) ng/mL; p=0,003), dan jenis kelamin perempuan (72,00% vs 28,00%; p=0,022) baik pada kelompok osteomielitis dan non-osteomielitis. Dari hasil analisis kurva ROC didapatkan parameter dengan hasil bermakna adalah LED (Cut-Off: 83,75 mm/jam; p=0,000) dan prokalsitonin (Cut-Off: 19,72 ng/mL; p=0,003) dalam penegakakan diagnosis osteomielitis pada pasien DM2.

Kesimpulan: Terdapat perbedaan yang bermakna dari segi nilai LED dan kadar prokalsitonin antara kelompok pasien DMT2 dengan osteomielitis dan tanpa osteomielitis. Dari ketiga parameter penanda inflamasi yakni CRP, LED dan prokalsitonin, nilai LED diketahui memiliki akurasi paling tinggi sebagai prediktor terjaidnya osteomielitis

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