Hubungan Antara Perubahan Mean Platelet Volume (MPV) dengan Mortalitas pada Pasien Sepsis, Sepsis Berat dan Syok Sepsis

Abstract

Latar Belakang: Sepsis merupakan penyebab utama kematian di unit perawatan intensif non-koroner. Peningkatan MPV pada keadaan sepsis dianggap sebagai kompensasi terhadap percepatan destruksi platelet dan tertekannya respon sumsum tulang. Sehingga MPV dianggap sebagai suatu petunjuk adanya inflamasi, aktivitas penyakit dan keberhasilan dari pengobatan. Tujuan penelitian:UntukmengetahuihubunganperubahanMPVdenganmortalitaspadapasien sepsis, sepsis beratdansyok sepsis, dan hubunganantaraperubahanMPVdenganskor APACE II. Metode penelitian: Dilakukan penelitian kohort prospektif pada 50 pasien sepsis yang masuk ke UGD RS Adam Malik pada bulan Januari- Agustus 2017.Data yang diambil adalah skor APACHE II, MPV saat masuk UGD (MPV1), setelah 72 jam rawatan (MPV2), danΔ MPV2-1.Kemudian dilihat mortalitas pasien dalam 28 hari. Pasien dikelompokkan kedalamsurvive dan non survive. Hasil: Pada pasien sepsis, terdapat perbedaan rerataΔ MPV2-1yang bermakna pada kelompok survive (-0,11 ±0,40) dan non survive(0,34 ±0,58), p = 0,021, tetapi tidak berbeda bermaknapada sepsis beratdansyok sepsis.Juga tidak ditemukan hubungan yang bermakna antara ΔMPV2-1 dengan skor APACHE II. Kesimpulan: ΔMPV2-1berbeda bermakna antara kelompok survive dan non survive pada pasien sepsis, tetapi tidak berbeda bermaknapada sepsis beratdansyok sepsis.

Background: Sepsis is a leading cause of death in a non-coronary intensive care unit. Increased MPV in sepsis is seen as a compensation of the acceleration of platelet destruction and suppression of bone marrow response. Thus, MPV is considered as an indication of inflammation, disease activity and efficacy of treatment. Objective: To investigate the association of MPV change with mortality in septic patients, severe sepsis and septic shock, and the corellation between MPV change and APACE II score. Methods: A prospective cohort study was performed on 50 sepsis patients admitted to the Adam Malik Hospital Emergency Unit from January to August 2017. The data collected were APACHE II score, MPV at admission (MPV1), after 72 hours of treatment (MPV2), and Δ MPV2-1. Then we monitor patient's mortality within 28 days. Patients were categorized into survive and non survive. Results: In septic patients, there was a significant difference in mean Δ MPV2-1 in the survival group (-0.11 ± 0.40) and non survive (0.34 ± 0.58), p = 0.021, but not significantly different in severe septic and septic shock. There was also no significant corellation between ΔMPV2-1 and APACHE II score. Conclusions: Δ MPV2-1 differed significantly between survival and non survival groups in septic patients, but did not differ significantly in severe septic and septic shock patients.