Tesis

Faktor-faktor Risiko Kejadian Sindrom Pasca Trombosis = Risk Factors Of Post Thrombotic Syndrome.

Latar belakang: Trombosis vena dalam (deep vein thrombosis/DVT)dapat menyebabkan komplikasi jangka panjang berupa sindrom pasca thrombosis (Post Thrombotic Syndrome/PTS)yang menurunkan kualitas hidup pasien. Tujuan: mengetahui proporsi dan faktor risiko PTS pada DVT ekstremitas bawah. Metode: Penelitian ini merupakan studi kohort retrospektif sejak Juli 2014 hingga September 2015 di RS Cipto Mangunkusumo Jakarta. Subjek adalah pasien dengan DVT pada tungkai bawah yang dibuktikan melalui USG (ultrasonografi)doppler dalam waktu 3 bulan sebelum penelitian. Gejala dan tanda PTS dinilai dengan menggunakan skala Villalta. Hasil: Penelitian ini melibatkan 91 subjek dengan median hari saat diagnosis DVT sampai dengan pemeriksaan PTS didapatkan 748 hari. Gejala dan tanda PTS yang paling banyak didapatkan adalah rasa berat (63,9%)dan hiperpigmentasi kulit (77,5%). PTS didapatkan pada 49 subjek (53,8%) dan mayoritas didapatkan dengan PTS derajat ringan (69,3%). Jenis kelamin perempuan (RR 1.48, IK 95% 0,97-2.42)dan letak trombus proksimal-distal meningkatkan risiko terjadinya PTS (RR 1.35, IK 95% 0.85-2.13), akan tetapi tidak signifikan secara statistik. Kesimpulan: Proporsi PTS pasca 3 bulan pasca terjadinya DVT ekstremitas bawah sebesar 53,8 %. Jenis kelamin perempuan dan lokasi trombus proksimaldistal meningkatkan risiko terjadinya PTS.
Kata kunci: Trombosis vena dalam, sindrom pasca trombosis, faktor risiko



Background: Post thrombotic syndrome (PTS) is a frequent long term complication of deep vein thrombosis (DVT) that decreases patient’s quality of life. Objective: The aim of this study is to determine the frequency and risk factors of PTS after DVT of the lower limb. Method: A retrospective cohort study was conducted from July 2014 until September 2015 at Cipto Mangunkusumo Hospital. The inclusion criteria were subjects diagnosed with lower limb DVT which was confirmed by Doppler ultrasound examination within 3 months prior the study. The diagnosis of PTS was assessed using Villalta scale. Result: There were ninety-one subjects recruited in this study. The median time since DVT diagnosis to evaluation of PTS was 748 days. The frequency of PTS in this study was 53,8%, and 69,3% of subjects had mild degree of PTS. The most frequent signs and symptoms were heavy sensation (63,2%) and skin hyperpigmentation (77,5%) in the affected limbs. The risk of PTS were increased in female gender (RR 1.48, 95%CI 0,97-2.42]) and in the combination of proximal deep vein plus calf vein thrombus location (RR 1.35, 95%CI 0.85-2.13]), but neither were statistically significant. Conclusion: The frequency of PTS after DVT diagnosis was 53,8%. The risk of PTS were increased in female gender and DVT in proximal deep vein plus calf vein thrombus location.
Keywords: Deep vein thrombosis, post thrombotic syndrome, risk factors.