Hubungan Antara Facial Injury Severity Scale (FISS) dengan Cedera Kepala dan Cedera Leher di RSUP H. Adam Malik Medan

Abstract

Latar Belakang Trauma maksilofasial merupakan trauma khusus karena dapat menyebabkan gangguan sejumlah fungsi penting pada wajah. Pasien dengan trauma maksilofasial sangat beresiko tinggi mengalami cedera kepala dan leher. Facial Injury Severity Scale (FISS) merupakan sistem penilaian klinis untuk melihat tingkat keparahan trauma maksilofasial, memprediksi nilai prognostik pasien trauma maksilofasial dan sebagai sarana penelitian. Tujuan dari penelitian ini untuk mengetahui hubungan antara Facial Injury Severity Scale (FISS) dengan cedera kepala dan cedera leher di RSUP H. Adam Malik Medan. Metode Penelitian Penelitian ini bersifat analitik dengan desain cross sectional. Selama kurun waktu April sampai Mei 2018 didapatkan 31 pasien trauma maksilofasial berusia > 18 tahun dan telah dilakukan pemeriksaan Head CT Scan dan X Ray leher dimasukkan dalam penelitian ini. Pasien trauma maksilofasial yang mengalami hematom, ekskoriasi dan memiliki hasil pemeriksaan penunjang yang normal tidak ikut dalam penelitian ini. Variabel pada penelitian ini adalah FISS dan cedera kepala. Variabel cedera kepala dibagi menjadi lesi intrakranial dan GCS. Kemudian dilakukan analisis data untuk menilai korelasi antara FISS dengan GCS menggunakan uji korelasi Spearman dan untuk menilai hubungan FISS dengan lesi intrakranial menggunakan uji T tidak berpasangan. Hasil Penelitian Dari 31 pasien trauma maksilofasial ini didapatkan 23 (74,2%) orang laki-laki, rerata umur 25,84 ± 11,45, rerata FISS adalah 3,00 ± 1,43, lokasi fraktur terbanyak pada mandibula 12 (38,7%) pasien, tidak dijumpai cedera leher pada seluruh pasien (100%), etiologi tersering karena kecelakaan lalu lintas khususnya pengendara sepeda motor sebanyak 30 (96,7%) pasien, tidak memakai helm 26 (83,9%) pasien, dan mengalami cedera kepala ringan sebanyak 27 (87,1%) pasien dengan rerata FISS cedera kepala ringan 3,07 ± 1,46. Rerata FISS tertinggi terdapat pada kelompok EDH (4,00 ± 1,00) dan open depressed fracture dengan pneumocephali (4,00 ± 1,45). Uji korelasi Spearman antara FISS dengan GCS menunjukkan tidak terdapat hubungan yang signifikan (r = 0,276, p=0,133). Uji T tidak berpasangan untuk menilai hubungan FISS dengan lesi intrakranial menunjukkan tidak terdapat hubungan yang signifikan (p=0,610). Kesimpulan Tidak ada hubungan antara FISS dengan GCS dan lesi intrakranial.

Background Maxillofacial trauma is a special trauma because it can cause impairment of a number of important functions on the face. Patients with maxillofacial trauma are highly at risk for head and neck injury. Facial Injury Severity Scale (FISS) is a clinical assessment system to look at the severity of maxillofacial trauma, predict the prognostic value of maxillofacial trauma patients and as a research tool. The purpose of this study was to determine the relationship between Facial Injury Severity Scale (FISS) with head injury and neck injury at RSUP H. Adam Malik Medan. Methods This design of this study is an analytical study with cross sectional design. 31 patients who were diagnosed of having concomitant maxillofacial and head injury by appropriate skull X-Ray and CT Scan of brain were included in this study. Maxillofacial trauma patients who were experienced with hematoma, excoriation and had normal investigative results did not participate in the study. Information’s based on age, sex, mode of injury, pattern of facial and head injury, GCS score and type of head injury was taken for each case. The variables in this study were FISS and head injury. Variable head injuries are divided into intracranial lesions and GCS. The data between FISS and GCS were analyzed with Spearman correlation test and to assess the relationship of FISS with intracranial lesions using ANOVA test. Results 31 maxillofacial trauma patients which consist of 23 (74.2%) males participated in this study. Mean ± SD of patient’s age was 25.84 ± 11.45. The FISS scores was calculated for each patient (average FISS: 3.00 ± 1.43, range 1 to 6. Mandible was the most commonly fractured facial bone (38,7%). Majority of the patients had mild head injury (87,1%) and there was no cervical injury was present in all patients (100%). The most frequent etiology was due to traffic accidents, especially motorcyclists as many as 30 (96.7%) patients and did not wear helmet in 26 (83.9%) patients. The highest mean FISS patients based on the type of head injury was in mild head injury group (3.07 ± 1.46). The highest mean FISS was in the EDH group (4.00 ± 1.00) and open depressed fracture with pneumocephalus (4.00 ± 1.45). Spearman correlation test between FISS and GCS didn’t give statistically significant result and showed low correlation (r = 0,276, p = 0,133). The relation between FISS and intracranial lesions using T independent test did not show significant result (p = 0,610). Conclusion There is no relationship between Facial Injury Severity Scale (FISS) with GCS and intracranial lessions.