Tesis

Hubungan Waktu Respon Code Stroke Dengan Luaran Klinis Dan Luaran Fungsional Pasien Stroke Iskemik Akut Yang Dilakukan Trombektomi Mekanik Di Rsupn Cipto Mangunkusumo Pada Tahun 2017-2022 = Correlation Between Code Stroke Response Time With Clinical And Functional Outcomes Of Acute Ischemic Stroke Patients Underwent Mechanical Thrombectomy At Rsupn Cipto Mangunkusumo In 2017- 2022.

Latar belakang: Code stroke merupakan strategi deteksi dini dan tatalaksana yang mencakup pre- hingga intra-hospital guna menurunkan angka mortalitas dan morbiditas akibat stroke. Trombektomi mekanik merupakan salah satu strategi tatalaksana pilihan yang luarannya dapat dipengaruhi oleh response time code stroke di fase pre dan intra hospital. Studi ini bertujuan untuk mengevaluasi faktor-faktor pre- dan intra-hospital khususnya response time yang mempengaruhi luaran trombektomi mekanik pada stroke iskemik. Metode: Studi potong lintang dilakukan pada pasien stroke iskemik teraktivasi code stroke yang menjalani trombektomi mekanik di RSCM pada 2017-2021. Data diambil dari rekam medik. Luaran klinis dinilai berdasarkan NIHSS, sedangkan luaran fungsional berdasarkan mRS. Hasil: Sejumlah 40 subjek masuk kriteria inklusi dan dianalisis Rerata usia pada sampel penelitian adalah 55,0812,63 tahun, dengan jenis kelamin terbanyak adalah perempuan (n=21; 52,5%) diikuti laki-laki (n=19; 47,5%). Faktor risiko yang paling banyak ditemukan pada subjek adalah hipertensi (n=22; 52,4%) dan merokok (n=21; 52,2%). rerata Door-toGroin Puncture (DTG) 296,23136.65, dan Door-to-Recanalization (DTR) 332 menit (94-770). mTICI dengan rekanalisasi minimal (n=2 ; 5%), rekanalisasi sebagian (n=14 ; 35%), rekanalisasi sempurna (n=24 ; 60%). Door to groin puncture (DTG) berhubungan dengan selisih NIHSS berdasarkan uji korelasi Spearman (p=0,017). Door to recanalization (DTR) juga berhubungan dengan selisih NIHSS berdasarkan uji korelasi Spearman (p=0,04) Kesimpulan: Response time code stroke yang lebih cepat, khususnya door to groin puncture (DTG) dan door to recanalization (DTR), memiliki korelasi positif dengan perbaikan luaran klinis pada pasien stroke yang dilakukan trombektomi mekanik.
Kata Kunci : Code Stroke, response time code stroke, luaran, trombektomi mekanik, Door-to-Groin Puncture, Door-to-Recanalization


Background: Code stroke is an early detection and management strategy that includes pre- to intra-hospital to reduce mortality and morbidity rates due to stroke. Mechanical thrombectomy is one of the preferred management strategies whose outcomes can be influenced by the stroke response time code in the pre- and intra-hospital phases. This study aims to evaluate pre-and intra-hospital factors, especially response time, which influence the outcome of mechanical thrombectomy in ischemic stroke. Method: A cross-sectional study was conducted on code stroke activated ischemic stroke patients who underwent mechanical thrombectomy at RSCM in 2017-2021. Data is taken from medical records. Clinical outcomes were assessed based on NIHSS, while functional outcomes were based on mRS. Result: A total of 40 subjects met the inclusion criteria and were analyzed. The average age of the research sample was 55.0812.63 years, with the most common gender being women (n=21; 52.5%) followed by men (n=19; 47, 5%). The risk factors most commonly found in subjects were hypertension (n=22; 52.4%) and smoking (n=21; 52.2%). mean Door-to-Groin Puncture (DTG) 296.23136.65, and Door-to-Recanalization (DTR) 332 minutes (94-770). mTICI with minimal recanalization (n=2 ; 5%), partial recanalization (n=14 ; 35%), complete recanalization (n=24 ; 60%). Door to groin puncture (DTG) was associated with the difference in NIHSS based on the Spearman correlation test (p=0.017). Door to recanalization (DTR) is also related to the difference in NIHSS based on the Spearman correlation test (p=0.04) Conclusion: Fast codes stroke response time, especially door to groin puncture (DTG) and door to recanalization (DTR), have a positive correlation with improved clinical outcomes in stroke patients undergoing mechanical thrombectomy.
Keywords: Code Stroke, response time code stroke, outcome, mechanical thrombectomy, Door-to-Groin Puncture, Door-to-Recanalization