Research Article

Hubungan indeks platelet dengan derajat keparahan penyakit demam berdarah dengue pada anak di RSUD Wangaya

Valerie Michaela Wilhelmina , I Wayan Bikin Suryawan, Kadek Suarca

Valerie Michaela Wilhelmina
General Practitioner-Intern, Department of Pedatrics Wangaya Regional Hospital Denpasar, Bali, Indonesia. Email: valeriemwr@gmail.com

I Wayan Bikin Suryawan
Pediatrician, Department of Pediatrics Wangaya Regional Hospital Denpasar, Bali, Indonesia

Kadek Suarca
Pediatrician, Department of Pediatrics Wangaya Regional Hospital Denpasar, Bali, Indonesia
Online First: August 31, 2021 | Cite this Article
Wilhelmina, V., Suryawan, I., Suarca, K. 2021. Hubungan indeks platelet dengan derajat keparahan penyakit demam berdarah dengue pada anak di RSUD Wangaya. Intisari Sains Medis 12(2): 635-639. DOI:10.15562/ism.v12i2.992


Background: Indonesia is an endemic country for Dengue Hemorrhagic Fever (DHF). Over 80% of children at age ?10 in Indonesia have been infected with dengue at least once. Dengue shock syndrome (DSS), as a severe clinical manifestation of DHF, has a high risk of mortality. The wide spectrum of dengue clinical manifestations poses a challenge to predict the progression of dengue infection into severe symptoms. Platelet indices (PI) are readily available laboratory parameters that mark the activity and quality of platelets. The purpose of this study is to investigate PI profile on pediatric DHF and the association with disease severity.

Methods: This is an analytical observational study with a cross-sectional design. Samples are obtained consecutively from secondary data of children diagnosed with DHF in Wangaya Regional Hospital. Chi-square analysis was used to assess the association between groups of platelet indices; mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), and plateletcrit (PCT) with severity parameter, namely; DHF grade, length of hospitalization, shock, and bleeding. 

Results: 150 subjects were included in the study. Bivariate analysis shows that MPV, PDW, and P-LCR does not correlate with any of the severity parameters. There is a significant correlation between PCT with the length of hospitalization (p=<0.001), shock (p=<0.001), and DHF grade (p=<0.001). PCT does not correlate with bleeding.

Conclusion: There is a significant association between PCT PI and several parameters of DHF severity. PCT can be considered to predict DHF grade, length of hospitalization, and shock.

 

Latar belakang: Indonesia merupakan negara endemis Demam Berdarah Dengue (DBD). Lebih dari 80% anak usia ?10 tahun di Indonesia telah terinfeksi dengue setidaknya satu kali. Sindrom syok dengue (SSD) sebagai manifestasi klinis berat dari DBD memiliki resiko kematian yang tinggi. Spektrum manifestasi klinis yang luas menjadi tantangan untuk memprediksi DBD yang akan berujung menjadi gejala berat. Indeks platelet (IP) merupakan parameter laboratorium yang mudah didapat dan menggambarkan aktivitas dan kualitas platelet. Tujuan dari studi ini adalah untuk mempelajari profil IP pada penyakit DBD anak dan hubungannya terhadap derajat keparahan penyakit.

Metode: Studi penelitian merupakan penelitian observasional analitik dengan desain potong lintang. Sampel diambil dari data sekunder pasien anak terdiagnosa DBD di unit rawat inap RSUD Wangaya dengan metode consecutive sampling. Analisis chi-square digunakan untuk menilai hubungan kelompok Indeks Platelet; mean platelet volume (MPV), platelet distribution width (PDW), platelet large cell ratio (P-LCR), dan plateletcrit (PCT) dengan parameter derajat keparahan yaitu grade DBD, lama rawat, syok, dan perdarahan.

Hasil: Sebanyak 150 subjek masuk dalam kriteria inklusi. Analisis bivariat menunjukkan MPV, PDW, dan PLCR tidak berhubungan dengan parameter derajat keparahan. Terdapat hasil signifikan PCT dengan lama rawat (p=<0,001), syok  (p=<0,001), dan grade DBD (p=<0,001). PCT tidak berhubungan dengan perdarahan.

Kesimpulan: Terdapat hubungan bermakna antara IP PCT dengan beberapa parameter derajat keparahan DBD. PCT dapat dipertimbangkan untuk memprediksi derajat keparahan penyakit yaitu grade DBD, lama rawat, dan syok.

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