Hubungan antara Platelet Lymphocyte Ratio (PLR) dan Neutrofil Lymphocyte Ratio (NLR) dengan amputasi pasca intervensi endovaskular pada pasien Peripheral Artery Disease (PAD) Rutherford 2–4 di RSUP Sanglah, Bali, Indonesia

Ade Sinyo Aristantrisna; Ketut Putu Yasa; I Gde Raka Widiana

doi:10.15562/ism.v11i3.819

Hubungan antara Platelet Lymphocyte Ratio (PLR) dan Neutrofil Lymphocyte Ratio (NLR) dengan amputasi pasca intervensi endovaskular pada pasien Peripheral Artery Disease (PAD) Rutherford 2–4 di RSUP Sanglah, Bali, Indonesia

Ade Sinyo Aristantrisna ,

Ketut Putu Yasa ,

I Gde Raka Widiana ,

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DOI: https://doi.org/10.15562/ism.v11i3.819 |
Published: 2020-12-01

Abstract

Background: Endovascular intervention is an effort to reduce amputation number in Peripheral Artery Disease (PAD) patients. The latest studies show a correlation between platelet lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) to the prognosis of PAD. This study aims to evaluate if PLR and NLR can be used to determine the prognosis of PAD patients.

Methods: An observational analytic study using a cross sectional approach has been conducted among 56 patients with PAD. The research was conducted in Sanglah Hospital Medical Report room Denpasar, using a patient medical report from January 2014 to December 2018. Variables assessed in this study include NLR, PLR, and ROC analysis to determine the cut-off point used in this study. Data were analyzed using SPSS version 23 for Windows.

Results: The ROC analysis results showed that the cut-off point value of 140.5 on the PLR based on the Youden Index had a significant sensitivity level of 75% and a specificity of 64.3% (AUC = 0.739; p = 0.02). While the cut point was 3.14 for the NLR, which had a sensitivity level of 82% and a specificity of 75% (AUC = 0.844; p <0.001). PLR values ? 140.5 had a significant 2.4 times chance of occurrence of amputation after endovascular intervention compared to patients who had PLR values <140.5 (p <0.001; 95% CI = 1.233-4.746). Patients with an NLR ? 3.14 had a 3.9 times chance of having an amputation after the endovascular intervention than patients who had an NLR <3.14 (p <0.001; 95% CI = 1.770 -8.981).

Conclusion: High PLR and NLR are associated with the risk of amputation after endovascular intervention in PAD Rutherford 2–4.

Latar Belakang: Salah satu usaha mengurangi angka amputasi pada pasien Periheral Artery Diseasse (PAD) adalah dengan intervensi endovascular. Beberapa studi terbaru menunjukkan adanya hubungan antara Platelet Lymphocyte Ratio (PLR) dan Neutrophil Lymphocyte Ratio (NLR) terhadap prognosis PAD. Penelitian ini bertujuan untuk mengetahui apakah PLR dan NLR dapat dipergunakan untuk menentukan prognosis pasien PAD.

Metode: Penelitian observasional analitik dengan pendekatan potong-lintang dilakukan terhadap 56 pasien dengan GAD. Tempat penelitian dilakukan di rekam medik RSUP Sanglah Denpasar. Pengambilan data penelitian adalah rekam medis Januari tahun 2014 sampai dengan Desember 2018. Variabel yang dinilai pada penelitian ini meliputi NLR, PLR, dan analisis ROC untuk menentukan titik potong (cut-off) yang dipergunakan pada penelitian ini. Data dianalisis dengan SPSS versi 23 untuk Windows.

Hasil: Hasil analisis ROC menunjukkan bahwa nilai titik potong 140,5 pada PLR berdasarkan Youden Indeks yang memiliki tingkat sensitivitas 75% dan spesifitas 64,3% secara bermakna (AUC=0,739; p=0,02). Sedangkan titik potong 3,14 pada NLR yang memiliki tingkat sensitivitas 82% dan spesifitas 75% (AUC=0,844; p<0,001). Nilai PLR ? 140,5 memiliki peluang 2,4 kali secara bermakna untuk terjadi amputasi pasca intervensi endovaskular dibandingkan dengan pasien yang memiliki nilai PLR < 140,5 (p<0,001; 95% IK=1,233-4,746). Pasien dengan NLR ? 3,14 memiliki peluang 3,9 kali untuk terjadi amputasi pasca intervensi endovaskular dibandingkan dengan pasien yang memiliki NLR <3,14 (p < 0,001; 95% IK=1,770 -8,981).

Kesimpulan: PLR dan NLR yang tinggi meningkatkan resiko amputasi pada pasien PAD Rutherford 2-4 yang sudah mendapatkan terapi intervensi endovascular

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