Korelasi Keterlibatan Katup dengan Status Nutrisi pada Anak dengan Penyakit Jantung Rematik

Abstract

Background : Malnourished are common in heart disease patients and are associated with increased morbidity and mortality. Likewise, in pediatrics rheumatic heart disease, malnourished can occur in relation to the severity of the valves lesions and tend to be most severe in lesions associated with congestive heart failure (CHF). However, data regarding valve involvement in the incidence of nutritional deficiencies in children with rheumatic heart disease is still limited. Objective : To determine the correlation valve involvement and nutritional status in pediatrics rheumatic heart disease, especially based on the severity of the valve, the type of valve abnormality and the number of valves involved. Methods : An analytical cross-sectional study was conducted on pediatrics rheumatic heart disease patients in Haji Adam Malik Hospital, Medan. Secondary data was taken from medical records, from January 2020 – October 2023. Valve involvement assessment was based on the type of valve lesion, the number of valves involved, and the degree of valve severity assessed based on a simple scoring that the author had made based on the severity of the valve lesion that occurred according to the guidelines. Examination of nutritional status according to anthropometric measurements. The correlation test uses Spearman, where the p value <0.05 is considered significant. Results : A total of 90 children were included in this study. As many as 53.4% of patients were malnourished, 7.8% of whom were severe malnourished. The majority of children with mitral regurgitation were 97.8%, with 57.8% of them having severe mitral regurgitation. The mean degree of valve severity was 5.39 with the lowest value being 1 and the highest being 12. The mean of valve lesions experienced was 2.4 with the lowest value being 1 and the highest being 4. There was no significant relationship between the degree of valve severity, type of valve abnormality, number of valves affected, the incidence of congestive heart failure and pulmonary hypertension with nutritional status. Congestive heart failure is a factor that significantly influences mortality in patients (p=0.004). Conclusion: There is no significant correlation between valve involvement and nutritional status in pediatrics rheumatic heart disease. Congestive heart failure is a factor that significantly influences mortality in pediatrics rheumatic heart disease.