Tesis

Disnatremia Pada Cedera Otak Traumatik dan Faktor-faktor Yang Berhubungan Di Rumah Sakit Cipto Mangunkusumo: Kajian Terhadap Usia, Jenis Kelamin, Beratnya Cedera Otak, Abnormalitas CT scan Kepala, dan Mekanisme Trauma = Dysnatremia in Traumatic Brain Injury and Associated Factors at Cipto Mangunkusumo Hospital: A Study of Age, Gender, Severity of Brain Injury, Head CT Scan Abnormalities, and Trauma Mechanism.

Pendahuluan: Cedera Otak Traumatik (COT) merupakan salah satu penyebab utama morbiditas dan mortalitas. Disnatremia, yaitu ketidakseimbangan kadar natrium (hiponatremia atau hipernatremia), sering terjadi pada pasien COT dan dapat memperburuk luaran klinis. Data mengenai disnatremia pada pasien COT di Indonesia, khususnya di RSCM, masih terbatas. Metode: Penelitian ini merupakan studi kasus-kontrol retrospektif terhadap pasien COT yang datang ke IGD RSCM periode Juli 2022-Oktober 2024. Sebanyak 240 subjek diteliti, terdiri dari 80 pasien disnatremia dan 160 pasien normonatremia. Analisis bivariat dilakukan dengan uji chi-square dan regresi logistik digunakan untuk analisis multivariat. Hasil: Disnatremia ditemukan pada 20% pasien COT. Analisis multivariat menunjukkan bahwa jenis kelamin (p=0,043; OR 1,942; IK95% 1,021 -3,694) dan abnormalitas CT scan kepala (p=0,004; OR 2,494; IK95% 1,345-4,626) berhubungan signifikan dengan kejadian disnatremia. Setelah disesuaikan dengan terapi hiperosmolar, abnormalitas CT scan kepala tetap menjadi faktor yang bermakna. Simpulan: Jenis kelamin dan abnormalitas CT scan kepala merupakan faktor yang berhubungan secara signifikan dengan disnatremia pada pasien COT. Pemantauan kadar natrium sangat penting, terutama pada pasien perempuan dan pasien dengan kelainan pada CT scan kepala.
Kata kunci: disnatremia, hiponatremia, hipernatremia, cedera otak traumatik, CT scan kepala, GCS


Introduction: Traumatic Brain Injury (TBI) is a major cause of morbidity and mortality. Dysnatremia (hyponatremia or hypernatremia) is common in TBI patients and can worsen clinical outcomes. Limited data exist regarding dysnatremia in TBI patients in Indonesia, especially at Dr. Cipto Mangunkusumo Hospital (RSCM). Methods: This was a retrospective case-control study of TBI patients who presented to the RSCM emergency department from July 2022 to October 2024. A total of 240 subjects were included, consisting of 80 patients with dysnatremia and 160 with normonatremia. Bivariate analysis was conducted using the chi-square test, and logistic regression was performed for multivariate analysis. Results: Dysnatremia was identified in 20% of TBI patients. Multivariate analysis revealed that sex (p=0.043; OR 1.942; 95% CI 1.021 -3.694) and head CT scan abnormalities (p=0.004; OR 2.494; 95% CI 1.345-4.626) were significantly associated with dysnatremia. After adjusting for hyperosmolar therapy as a confounding factor, head CT scan abnormalities remained significantly associated with dysnatremia. Conclusion: Sex and head CT scan abnormalities are significantly associated with dysnatremia in TBI patients. Close monitoring of serum sodium is crucial, especially in female patients and those with abnormal CT scan results.
Keywords: dysnatremia, hyponatremia, hypernatremia, traumatic brain injury, head CT scan abnormalities, GCS