Tesis

Hubungan Gangguan Kognitif dengan Kualitas Hidup pada Pasien dengan Lupus Eritematosus Sistemik = Relationship ofCognitive Impairment with Quality of Life in Patients with Systemic Lupus Erythematosus.

Latar belakang: Gangguan Kognitif adalah salah satu manifestasi dari NPSLE. Pasien LES dengan gangguan kognitif telah dilaporkan memiliki dampak yang besar pada kualitas hidup dan berpengaruh besar pada peran sosial pasien LES. Tujuan: Mengetahui prevalensi gangguan kognitifpada pasien LES dan hubungan gangguan kognitif dengan kualitas hidup pada pasien LES. Metode: Penelitian ini merupakan studi potong lintang pada pasien LES di poliklinik rawat jalan Rumah Sakit Cipto Mangunkusumo, Jakarta. Data yang dikumpulkan adalah karakteristik pasien, hasil tes MoCA-Ina, LupusQol, dan HADS. Data karakteristik pasien meliputi usia, jenis kelamin, penyakit komorbid, aktivitas penyakit, penggunaan kortikosteroid dan imunosupresan lainnya, serta durasi penyakit. Analisis dilakukan dengan menggunakan uji T independen jika data terdistribusi normal, jika data tidak terdistribusi normal maka dilakukan uji statistik dengan menggunakan Uji Mann Whitney. Analisis multivariat regresi linier dilakukan untuk menilai pengaruh variabel perancu terhadap hubungan gangguan kognitif dengan kualitas hidup. Nilai p yang dianggap signifikan adalah < 0,05. Hasil: Dari 116 subjek, 112 (96,6%) adalah perempuan, dengan usia rerata (SB) 34,41 (10,15) tahun, memiliki tingkat pendidikan perguruan tinggi sebanyak 45 (38,8%). Durasi penyakit median (RIK) adalah 52 (16,75 - 109,5) bulan, dan yang memiliki komorbid sebanyak 41 (35,3%). Aktivitas penyakit berdasarkan penilaian MexSLEDAI adalah 2,75 (0-6), dengan keterlibatan organ terbanyak adalah mukokutaneus (90,5%) dan muskuloskeletal (91,4%). Sebagian besar pasien menggunakan kortikosteroid, sedangkan yang tidak menggunakan hanya 12 (10,3%) dan hidroksiklorokuin adalah penggunaan tertinggi sebesar 79 (68,1%). Depresi dan ansietas berdasarkan kuesioner HADS masing-masing 24 dan 44 subjek. Prevalensi gangguan kognitif pada pasien LES adalah 57,8%. Berdasarkan analisis bivariat dengan uji Mann Whitney, ditemukan bahwa kualitas hidup, yang dinilai dengan kuesioner LupusQoL, tidak berhubungan dengan gangguan kognitif. (p-value = 0,750). Kesimpulan: Lebih dari separuh subjek mengalami gangguan kognitif. Tidak ada hubungan antara gangguan kognitif dan kualitas hidup pada pasien LES.
Kata kunci: NPSLE, LES, gangguan kognitif, kualitas hidup


Background: Cognitive Impairment is one of the manifestations of NPSLE. SLE patients with cognitive impairment have been reported to have a major impact on quality of life and a major effect on the social role of SLE patients. Objective: This study aimed to find out prevalence of cognitive impairment in SLE patients and the relationship between cognitive impairment and quality of life in SLE patients. Method: This was a cross-sectional study of SLE patients from outpatient clinic Cipto Mangunkusumo Hospital, Jakarta. Data collected were patient characteristics, MoCA-Ina, LupusQol, and HADS test results. Data on patient characteristics included age, gender, comorbid diseases, disease activity, use of corticosteroids and other immunosuppressants, and duration of disease. The analysis was carried out using the independent T test if the data was normally distributed, if the data was not normally distributed then a statistical test was carried out using the Mann Whitney Test. Linear regression multivariate analysis was performed to assess the effect of confounding variables on the relationship between cognitive impairment and quality of life. The p value that was considered significant was < 0.05. Result: Of the 116 subjects, 112 (96.6%) were female, with a mean age of 34.41 (10.15) years, had tertiary level of educations at 45(38.8%). The duration of illness was 52 (16.75-109.5) months with 41 (35.3%) had comorbidities. Their disease activity based on Mex-SLEDAI assessment was 2.75 (0-6), with the most organ involvement of the participants were mucocutaneous (90.5%) and musculoskeletal (91.4%). Most of the patients were using corticosteroid as their therapy, while those who did not use was only 12 (10.3%) and hydroxychloroquine was the highest usage among the participants 79 (68.1%). Depression and anxiety were assessed with HADS questionnaire were 24 and 44, respectively. The prevalence of cognitive impairment in SLE patients was 57.8%. Based on bivariate analysis with the Mann Whitney test, it was found that the quality of life, which was assessed by the Lupus QoL questionnaire, there was no relationship between cognitive impairment and quality of life in SLE patients (p-value = 0.750). Conclusion: More than half of the subjects experienced cognitive impairment. There was no significant relationship between cognitive impairment and quality of life in SLE patients.
Keywords: NPSLE, SLE, cognitive impairment, quality of life