Tesis

Prediktor Defisiensi Seng Rambut dan Hubungannya dengan Derajat Beratnya Klinis Pneumonia Komunitas di Rumah Sakit Umum Pusat Nasional dr. Cipto Mangunkusumo = Predictors of Hair Zinc Deficiency and Its Association with the Severity of Community Acquired Pneumonia in dr. Cipto Mangunkusumo National General Hospital.

Latar Belakang : Defisiensi seng dapat menyebabkan gangguan imunitas yang memperberat manifestasi klinis dari pneumonia komunitas. Seng pada rambut merupakan biomarker yang potensial karena kadarnya lebih stabil. Namun, karena pemeriksaan kadar seng tidak rutin dilakukan, dibutuhkan prediktor klinis terkait profil pasien yang berisiko mengalami defisiensi seng, secara khusus pada pasien pneumonia komunitas. Tujuan : Mengetahui prediktor defisiensi seng rambut pada subjek pneumonia komunitas dan mengetahui hubungan antara defisiensi seng rambut dengan derajat beratnya klinis pneumonia komunitas. Metode : Penelitian ini merupakan penelitian potong lintang dengan menggunakan data primer. Sembilan puluh tiga pasien dewasa yang menjalani rawat inap di RSCM pada bulan Juli-Agustus 2023 disertakan dalam studi. Pengambilan sampel menggunakan metode consecutive sampling. Kadar seng rambut dianalisis dengan metode spektrofotometri. Asupan seng selama sebulan terakhir dinilai dengan menggunakan food frequency questionnaire semikuantitatif. Riwayat medis diperoleh dari rekam medis RS dan pemeriksaan laboratorium. Dilakukan uji bivariat menggunakan Chi-Square terhadap usia, jenis kelamin, status gizi, asupan seng, diabetes melitus, malabsorpsi, penyakit ginjal kronik, sirosis hepatis, HIV/AIDS, dan keganasan dengan defisiensi seng rambut. Identifikasi faktor prediktor defisiensi seng rambut dilakukan dengan uji multivariat regresi logistik. Selain itu juga dilakukan uji bivariat menggunakan Chi-square untuk menilai hubungan antara defisiensi seng rambut dan derajat beratnya pneumonia komunitas, kemudian dilakukan analisis multivariat terhadap variabel perancu. Hasil: Sepuluh koma tujuh lima persen (10,75%) pasien mengalami defisiensi seng rambut. Faktor prediktor defisiensi seng rambut pasien pneumonia komunitas yaitu diabetes melitus (PR 4,800; IK 95% 1,339 – 17,199) dan status HIV/AIDS (PR 6,000; IK 95% 1,356 – 26,544). Tidak didapatkan hubungan bermakna antara defisiensi seng rambut dan derajat beratnya klinis pneumonia komunitas. Kesimpulan: Prevalensi defisiensi seng rambut pada populasi studi ini yaitu 10,75%. Faktor prediktor defisiensi seng rambut pada pasien pneumonia komunitas antara lain diabetes melitus dan HIV/AIDS. Namun tidak didapatkan hubungan antara defisiensi seng rambut dengan derajat beratnya klinis pneumonia komunitas pada populasi studi ini.
Kata kunci: prediktor, defisiensi seng, seng rambut, pneumonia komunitas


Background: Zinc deficiency can cause immune disorders which can increase the severity of community-acquired pneumonia (CAP). One of the potential biomarker of zinc deficiency is hair zinc levels because it is more stable. However, because zinc levels are not routinely being tested, clinical predictors are needed to determine the profile of patients at risk of zinc deficiency, especially in CAP patients. Aim : To study about the predictors of hair zinc deficiency in CAP patients and to study the association between hair zinc deficiency and the severity of CAP. Methods: This study is a cross-sectional study using primary data. Ninety-three adult patients who were hospitalized at RSCM on July-August 2023 were included in this study. Sampling used the consecutive sampling method. Hair zinc levels were analyzed using the spectrophotometry. Zinc intake during the last month was assessed using a semiquantitative food frequency questionnaire. Medical history was obtained from hospital medical records and laboratory examinations. Bivariate tests using Chi-Square were performed on age, gender, nutritional status, zinc intake, diabetes mellitus, malabsorption, chronic kidney disease, liver cirrhosis, HIV/AIDS, and malignancies with hair zinc deficiency. Identification of predictors for hair zinc deficiency was carried out using a multivariate logistic regression test. Bivariate test was also performed using chisquare to assess the association between hair zinc deficiency and the severity of CAP, then a multivariate analysis was performed on confounding variables. Results: Ten point seven five percent (10.75%) of patients experienced hair zinc deficiency. Predictors for hair zinc deficiency in community-acquired pneumonia patients were diabetes mellitus (PR 4.800; 95% CI 1.339 – 17.199) and HIV/AIDS status (PR 6.000; 95% CI 1.356 – 26.544). There was no significant relationship between hair zinc deficiency and the severity of CAP. Conclusion: The prevalence of hair zinc deficiency in this study population was 10.75%. Predictors for hair zinc deficiency in community-acquired pneumonia patients are diabetes mellitus and HIV/AIDS. However, there was no association between hair zinc deficiency and the severity of CAP in this study population.
Keywords: predictors, zinc deficiency, hair zinc, community-acquired pneumonia