Hubungan Antara Early Oxygenation Level, Glycemic Gap, Stress Hyperglycemia Ratio dan Kadar Serum Feritin dengan Outcome Pasien Stroke Iskemik Akut dengan dan Tanpa Diabetes Melitus Tipe 2

Abstract

Ischemic stroke is one of the leading causes of death and long-term disability worldwide. Diabetes mellitus (DM) is a risk factor for stroke. Ischemic stroke is more severe in patients with type 2 DM and is also associated with poorer functional outcome and higher risk of death. Several prognostic indicators such as oxygenation status, acute hyperglycemic stress, and serum ferritin levels have been reported to be associated with acute ischemic stroke outcomes Objective This study aimed to examine the relationship between early oxygenation level, glycemic gap, stress hyperglycemia ratio and serum ferritin levels with the outcome of acute ischemic stroke patients with and without type 2 diabetes Methods This research is a correlative analytic with cross-sectional design. The study sample consisted of 40 ischemic stroke patients with and without type 2 DM. Early oxygenation level, glycemic gap, stress hyperglycemia ratio and serum ferritin levels were assessed based on blood laboratory results. Stroke outcome assessment using the NIHSS score was assessed on the first and seventh day of treatment Results In the ischemic stroke group with type 2 DM, the mean early oxygenation level was 315,82±69,01, the average glycemic gap was 8,49±68,66 mg/dL, the average stress hyperglycemia ratio was 23,6±14,01, the mean serum ferritin level was 615,57±415,56 ng/mL. In the ischemic stroke group without type 2 DM, the mean early oxygenation level was 326,85±64,24, the mean glycemic gap was -4,73±35,98 mg/dL, the average stress hyperglycemia ratio was 23,34±9,54. , the mean serum ferritin level was 382,85±188,12 ng/mL. There was a significant relationship between early oxygenation level, glycemic gap, stress hyperglycemia ratio and serum ferritin levels with the outcome of acute ischemic stroke patients with and without type 2 DM (p<0,05) Conclusion There was a significant relationship between early oxygenation level, glycemic gap, stress hyperglycemia ratio and serum ferritin levels with the outcome of acute ischemic stroke patients with and without type 2 diabetes (p<0.05)

Stroke iskemik menjadi salah satu penyebab utama kematian dan kecacatan jangka panjang di seluruh dunia. Diabetes melitus (DM) merupakan salah satu faktor risiko stroke. Stroke iskemik juga dijumpai lebih berat pada pasien dengan DM tipe 2 dan terkait dengan hasil yang lebih buruk dan risiko kematian yang lebih tinggi. Beberapa indikator prognostik seperti status oksigenasi, stres hiperglikemia akut, dan kadar serum feritin dilaporkan berkaitan dengan outcome stroke iskemik akut Tujuan Penelitian ini bertujuan untuk melihat hubungan antara early oxygenation level, glycemic gap, stress hyperglycemia ratio dan kadar serum feritin dengan outcome pasien stroke iskemik akut dengan dan tanpa DM tipe 2 Metode Penelitian ini bersifat analitik korelatif dengan desain potong lintang. Sampel penelitian terdiri dari 40 pasien stroke iskemik dengan dan tanpa DM tipe 2. Early oxygenation level, glycemic gap, stress hyperglycemia ratio dan kadar serum feritin dinilai berdasarkan hasil laboratorium darah. Penilian outcome stroke dengan menggunakan skor NIHSS dinilai pada hari pertama dan hari ke tujuh rawatan. Hasil Pada kelompok stroke iskemik dengan DM tipe 2 dijumpai rerata early oxygenation level sebesar 315,82±69,01, rerata glycemic gap sebesar 8,49±68,66 mg/dL, rerata stress hyperglycemia ratio sebesar 23,6±14,01, rerata kadar serum feritin sebesar 615,57±415,56 ng/mL. Pada kelompok stroke iskemik tanpa DM tipe 2 dijumpai rerata early oxygenation level sebesar 326,85±64,24, rerata glycemic gap sebesar -4,73±35,98 mg/dL, rerata stress hyperglycemia ratio sebesar 23,34±9,54, rerata kadar serum feritin sebesar 382,85±188,12 ng/mL. Terdapat hubungan yang siginifikan antara early oxygenation level, glycemic gap, stress hyperglycemia ratio dan kadar serum feritin dengan outcome pasien stroke iskemik akut dengan tanpa DM tipe 2 (p<0,05) Kesimpulan Terdapat hubungan yang siginifikan antara early oxygenation level, glycemic gap, stress hyperglycemia ratio dan kadar serum feritin dengan outcome pasien stroke iskemik akut dengan dan tanpa DM tipe 2 (p<0,05)