scholarly journals Hubungan Kadar Laminin Serum dengan Tingkat Kesadaran Menurut Skor FOUR pada Pasien Cedera Otak Akibat Trauma

e-CliniC ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 504
Author(s):  
Akbar S. Putera ◽  
Eko Prasetyo ◽  
Maximillian Ch. Oley ◽  
Fima L. F. G. Langi
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Regression Model ◽  
Emergency Surgery ◽  
Venous Blood ◽  
High Serum ◽  
Cross Sectional ◽  
Four Score ◽  
Cross Sectional Design ◽  
The Relationship

Abstract: Traumatic brain injury (TBI) could result in disorders of central nervous system (CNS). Serum laminin level and the FOUR score have both been suggested as predictors for the outcomes after TBI. This study was aimed to evaluate the relationship between serum laminin level and the FOUR score in TBI patients. This was an observational and analytical study with a cross-sectional design. Subjects were 32 patients with TBI and FOUR scores of 0-16 admitted at the Emergency Surgery Installation of Prof. Dr. R. D. Kandou Hospital. Venous blood sample for laminin was taken less than 24 hours after trauma. Assessment of the level of consciousness was determined by using the FOUR score at Emergency Surgery Installation admission <24 hours and observation after >24 hours. Proportional regression model was used to assess changes in FOUR score associated with laminin level. The results obtained 32 patients with TBI, mean laminin level was 818.4 pg/mL with range IQR 597.4-1235.4 pg/mL. In final regression model, each increase of one unit of pre-24 hours FOUR score decreased serum laminin level by 54.4 pg/mL (95% CI -76.3; 32.1 pg/mL, p<0.001). Same as the relationship occurred for the FOUR score after 24 hours, but the decrease was slightly smaller, at 37.2 pg/mL (95% CI -50.2; -24.3 pg/mL, p<0.001). FOUR scores with a high risk of mortality were more likely to be found in relatively high serum laminin levels. In conclusion, there is a relationship between serum laminin level and the FOUR score. Increase in serum laminin level is a potential alternative to lower FOUR score and to predictof poorer outcome in patient with TBI.Keywords: laminin; FOUR score; traumatic brain injury (TBI) Abstrak: Pada cedera otak akibat trauma (COT) sering terjadi gangguan saraf pusat. Laminin serum dan skor FOUR disarankan sebagai prediktor luaran setelah COT. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar laminin serum dan skor FOUR pada pasien COT. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Penelitian dilaksanakan pada 32 pasien dengan COT dan skor FOUR 0-16 yang masuk ke Instalasi Rawat Darurat Bedah (IRDB) RSUP Prof. Dr.R. D. Kandou, Manado. Sampel darah vena untuk pemeriksaan serum laminin diambil kurang dari 24 jam setelah trauma. Penilaian tingkat kesadaran ditetapkan dengan skor FOUR saat masuk IRDB <24 jam dan observasi setelah >24 jam. Model regresi proporsional digunakan untuk menilai hubungan kadar laminin serum dengan skor FOUR. Hasil penelitian mendapatkan 32 pasien dengan COT. Rerata kadar laminin serum 818,4 pg/mL dengan range IQR 597,4-1.235,4 pg/mL. Pada model regresi akhir, setiap peningkatan satu unit skor FOUR pra 24 jam rata-rata menurunkan kadar laminin serum sebesar 54,4 pg/mL (95% CI -76,3; 32,1 pg/mL, p<0,001). Hubungan sejenis terjadi untuk skor FOUR pasca 24 jam, tetapi nilai penurunannya sedikit lebih kecil, yakni 37,2 pg/mL (95% CI -50,2; -24,3 pg/mL, p<0,001). Skor FOUR dengan risiko mortalitas tinggi lebih cenderung ditemukan pada kadar laminin serum relatif tinggi. Simpulan penelitian ini ialah terdapat hubungan antara kadar laminin serum dengan skor FOUR. Peningkatan kadar laminin serum merupakan alternatif potensial skor FOUR yang lebih rendah untuk memrediksi luaran yang lebih buruk pada pasien COT.Kata kunci: laminin; skor FOUR; cedera otak akibat trauma (COT)

scholarly journals Hubungan antara dinamika suhu tubuh dan leukosit perifer dengan skala skor FOUR penderita cedera otak risiko tinggi

2016 ◽  
Vol 8 (3) ◽  
Author(s):  
Mulyoni Polapa ◽  
Eko Prasetyo ◽  
Maximillian Ch. Oley
Keyword(s):  
Brain Injury ◽  
Body Temperature ◽  
Secondary Brain Injury ◽  
Strongly Correlated ◽  
Cross Sectional ◽  
Peripheral Leukocyte ◽  
Four Score ◽  
Cross Sectional Design ◽  
The Relationship ◽  
Temperature Dynamic

Abstract: One third of patients died in the hospital are patients with secondary brain injury associated with increased intracranial pressure as the main clinical manifestation. Body temperature, inflammatory response, and brain injury are strongly correlated each other. The responses manifest as hyperthermia, leukocytosis, and disturbances in respiratory and heart rates. Prognosis determination is very important at the time in Intensive Care Unit. FOUR score scale involves four components, as follows: eye response, motor response, brainstem reflexes, and respiration. This study was aimed to obtain the relationship between body temperature dynamic and total peripheral leucocyte with FOUR score in patients with high risk brain injury due to trauma. This was an observational analytical study with a cross sectional design. There were 38 patients that fulfilled the inclusion criteria at Prof Dr. R. D. Kandou Hospital Manado. The relationships between body temperature dynamic and total peripheral leukocyte with FOUR score were statistically analyzed with Pearson regression and correlation analysis (SPSS Version 22.0). The results showed that there was a negative correlation between body temperature dynamic and FOUR score (P = 0.03) meanwhile the correlation between total peripheral leukocyte and FOUR score was not significant (P = 0.420). Conclusion: Body temperature dynamic dan total peripheral leucocyte can be included in the protocol of the management of patients with brain injury.Keywords: brain injury, neuroinflammation, FOUR score, temperature, leucocyteAbstrak: Sepertiga dari pasien meninggal di rumah sakit ialah pasien yang mengalami cedera otak sekunder dengan peningkatan tekanan intrakranial sebagai manifestasi klinik utama. Suhu tubuh, respon inflamasi, dan cedera otak sangat erat kaitannya. Respon ini dimanifestasikan dengan hipertermia, leukositosis, serta gangguan respirasi dan denyut jantung. Penentuan prognosis pada saat perawatan di Unit Perawatan Intensif sangat berperan. Skala skor FOUR (Full outline unresponsiveness) melibatkan penilaian dari empat komponen berikut, yaitu: respon mata, respon motorik, refleks batang otak dan pernapasan. Penelitian ini bertujuan untuk mencari hubungan antara dinamika suhu tubuh dan total leukosit perifer dengan skor FOUR pada pasien cedera otak risiko tinggi karena trauma. Jenis penelitian ini observasional korelatif analitik dengan desain potong lintang. Terdapat 38 pasien cedera otak resiko tinggi yang memenuhi kriteria inklusi di RSUP Prof. Dr. R. D. Kandou Manado. Hubungan antara dinamika suhu tubuh dan total lekosit perifer dengan skor FOUR dianalisis dengan analisis regresi korelasi Pearson menggunakan SPSS Versi 22.0. Hasil penelitian mendapatkan hubungan negatif antara dinamika suhu tubuh dengan skala skor FOUR penderita cedera otak risiko tinggi (P = 0,03) sedangkan hubungan antara leukosit perifer dan skala skor FOUR secara statistik tidak bermakna (P = 0,420). Simpulan: Penilaian dinamika suhu tubuh dan leukosit perifer dapat dijadikan pedoman dalam penatalaksanaan penderita cedera otak.Kata kunci: cedera otak, neuroinflamasi, skor FOUR, suhu, lekosit

scholarly journals Hubungan Kadar Interleukin 6 Serum dan Klasifikasi CT Marshal pada Penderita Cedera Otak Berat Akibat Trauma

2019 ◽  
Vol 11 (1) ◽  
pp. 41
Author(s):  
Mervin Manginte ◽  
Eko Prasetyo ◽  
Maximillian Ch. Oley
Keyword(s):  
Ct Scan ◽  
Interleukin 6 ◽  
Venous Blood ◽  
Cross Sectional ◽  
Coefficient Corrélation ◽  
Severe Tbi ◽  
Diffuse Injury ◽  
Cross Sectional Design ◽  
The Relationship ◽  
The Brain

Abstract: Increase of interleukin 6 (IL-6) level occurs in the brain after traumatic brain injury (TBI), however, studies about IL-6 as a prodictor based on CT-scan is still limited. This study was aimed to evaluate the relationship between serum IL-6 level and CT Marshall classification in patients with severe TBI. This was an observational study with a cross sectional design. There were 20 patients with severe TBI admitted at the Emergency Surgery Installation of Prof. Dr. R. D. Kandou Hospital Manado in this study. CT-scan was performed on them to determine the CT Marshall classification and to categorize the hemorrhage location (extra-axial, intra-axial, both), hemisphere (midline/diffuse, dextral, sinistral), and area (frontal, parietal, temporal, occipital, multiple). Venous blood sample used for IL-6 examination was drawn less than 24 hours after trauma. The results showed that mean IL-6 level was 22.0060 pg/mL (SD 4.64494 pg/mL). Patients were distributed relatively uniform in 4 detected categories (diffuse injury II, III, V, and VI) of CT Marshall classification. Final regression model consisted of IL-6, age, and temporal injury as predictors. The Spearman coefficient correlation showed rs = -0.005 (P=0.491). Conclusion: There was no significant relationship between serum Il-6 level and CT Marshall classification, albeit, both of them increased consistantly following the severity of TBI and could be potential predictors to determine the prognosis of severe TBI patients.Keywords: IL-6, CT Marshall, severe TBIAbstrak: Pada cedera otak berat akibat trauma (COBT) terjadi peningkatan ekspresi IL-6 di otak namun penelitian mengenai kemampuannya untuk memrediksi hasil berdasarkan klasifikasi CT scan masih terbatas. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar IL-6 serum dan klasifikasi CT Marshall pada pasien dengan COBT. Jenis penelitian ialah observasional dengan desain potong lintang. Hasil penelitian mendapatkan 20 pasien yang dirawat dengan COBT di IRDB RSUP Prof. Dr. R. D. Kandou Manado. CT-scan segera digunakan untuk menentukan klasifikasi CT Marshall dan untuk mengategorikan lokasi (ekstra-aksial, intra-aksial, keduanya), belahan (garis tengah/difus, dekstra, sisnitra), dan area otak yang terlibat dalam cedera. Sampel darah vena untuk IL-6 diambil kurang dari 24 jam setelah trauma. Hasil penelitian mendapatkan rerata kadar IL-6 22,0060 pg/mL (SD 4,64494 pg/mL). Pasien didistribusikan relatif seragam dalam empat kategori yang terdeteksi (difus cedera II, III, V, dan VI) dari klasifikasi CT Marshall. Model regresi akhir terdiri dari IL-6, usia, dan cedera pada area temporal sebagai prediktor. Korelasi antara kadar IL-6 serum dan klasifikasi CT Marshall dianalisis dengan koefisien korelasi Spearman dan mendapatkan rs = -0,005 (P=0,491). Simpulan: Walaupun secara statistik tidak terdapat hubungan bermakna antara kadar Il-6 serum dan CT Marshall namun keduanya secara konsisten meningkat mengikuti COBT dan dapat menjadi prediktor potensial untuk menentukan prognosis pada pasien dengan COBT.Kata kunci: IL-6, CT Marshall, COBT

The interactive effects of personality and burnout on knowledge sharing among teachers

2016 ◽  
Vol 44 (8) ◽  
pp. 1267-1280 ◽  
Author(s):  
Jinfeng Zhang ◽  
Mingjie Zhou ◽  
Jianxin Zhang
Keyword(s):  
Regression Model ◽  
Knowledge Sharing ◽  
Big Five ◽  
Big Five Personality Traits ◽  
Interactive Effects ◽  
Big Five Personality ◽  
Cross Sectional ◽  
Organizational Resource ◽  
Cross Sectional Design ◽  
The Relationship

Knowledge sharing is an important organizational resource and should be encouraged in the field of teaching. We used a cross-sectional design, and 796 teachers in primary or secondary schools completed measures of the Big Five personality traits, burnout, and knowledge sharing. The results showed that (a) in the regression model, the traits of extraversion and agreeableness were positively associated with knowledge sharing, but conscientiousness, openness, and neuroticism were not significant in predicting knowledge sharing; (b) burnout was negatively associated with knowledge sharing after controlling for personality; and (c) burnout moderated the relationship between personality and knowledge sharing; that is, compared with those with a high score for burnout symptoms, the relationship between personality and knowledge sharing was stronger for those with a low score for burnout symptoms. The results suggest that interventions aimed at reducing teachers' burnout might be helpful for improving their knowledge sharing.

scholarly journals Peningkatan Kadar Interleukin 10 Setelah Cedera Otak Berat akibat Trauma Berhubungan dengan Skor FOUR Rendah

2019 ◽  
Vol 11 (1) ◽  
pp. 47
Author(s):  
David Loing ◽  
Eko Prasetyo ◽  
Maxmillian Ch. Oley
Keyword(s):  
Serum Level ◽  
Venous Blood ◽  
Interleukin 10 ◽  
Equal Proportion ◽  
Forward Selection ◽  
Cross Sectional ◽  
Temporal Area ◽  
Severe Tbi ◽  
Four Score ◽  
The Relationship

Abstract: Serum level of interleukin 10 (IL-10) and the FOUR score have both been suggested as predictors for the outcomes after severe traumatic brain injury (TBI). Studies are limited, however, on how they are related to each other. This study was aimed to assess the relationship between serum level of IL-10 and the FOUR score in patients with severe TBI. This was an observational study with a cross sectional design. The study was conducted on 25 severe TBI patients with FOUR score of 0-14 consecutively admitted at the the Emergency Surgery Installation of Prof. Dr. R. D. Kandou Hospital. Classification of the hemorrhage location (extra-axial, intra-axial, both), hemisphere (midline/diffuse, dextral, sinistral), and area (frontal, parietal, temporal, occipital, multiple) was established by using CT scans. Venous blood sample for IL 10 was performed less than 24 hours after trauma. Binary logistic regression was used to model the relationship of interest, with covariates selected through stepwise forward selection. The results obtained 25 patients dominated by males (84%), with median age 31. Mean IL-10 was 107.3 pg/ml (SD 16.2 pg/ml). Median FOUR score was 10, with fairly equal proportion in the category of high (FOUR score 0-7; 48%) and moderate (FOUR score 8-14; 52%) mortality risks. Final regression model included age and injury on temporal area (yes, no) as covariates for IL-10. Adjusting for these variables, the average patients had about 1.12 (95% CI 1.01, 1.25) times higher odds for worse FOUR scores (0-7, high mortality risk) in each pg/ml addition of serum IL-10. Conclusion: The finding indicates that increased IL-10 level is a potential alternative to the lower FOUR score for predicting worse outcome in patients with severe TBI.Keywords: IL-10; FOUR score; TBIAbstrak: Interleukin 10 (IL-10) serum dan skor FOUR disarankan sebagai prediktor luaran setelah cedera otak akibat trauma (COT) berat namun penelitian mengenai hubungan keduanya masih terbatas. Penelitian ini bertujuan untuk menilai hubungan antara kadar IL-10 serum dan skor FOUR pada pasien dengan COT berat. Jenis penelitian ialah observasional dengan desain potong lintang. Penelitian dilaksanakan pada 25 pasien dengan COT berat dan skor FOUR 0-14 secara berurut masuk ke UGD Prof. Dr. R. D. Kandou. Klasifikasi lokasi perdarahan (ekstra-aksial, intra-aksial, keduanya), hemisfer (garis tengah/difus, dekstra, sinistra), dan area (frontal, parietal, temporal, oksipital, multipel) ditetapkan dengan CT scan. Sampel darah vena untuk pemeriksaan IL-10 diambil kurang dari 24 jam setelah trauma. Regresi logistik biner digunakan pada model untuk hubungan ketertarikan dan kovariat stepwise forward. Hasil penelitian mendapatkan 25 pasien didominasi oleh laki-laki (84%), median usia 31 tahun. Rerata IL-10 107,3 pg/ml (SD 16,2 pg/ml). Median skor FOUR 10 dengan proporsi berimbang pada kategori tinggi (skor FOUR 0-7; 48%) dan sedang (skor FOUR 8-14; 52%) risiko mortalitas. Model regresi akhir termasuk usia dan cedera area temporal (ya, tidak) sebagai kovariat untuk IL-10. Rata-rata pasien memiliki sekitar 1,12 (95% CI 1,01-1,25) kali peluang lebih tinggi untuk skor FOUR yang lebih buruk (0-7, risiko kematian tinggi) pada setiap peningkatan 1 pg/ml kadar IL-10 serum. Simpulan: Temuan ini menunjukkan peningkatan IL-10 sebagai alternatif potensial terhadap skor FOUR yang lebih rendah untuk memrediksi hasil yang lebih buruk pada pasien dengan COT berat.Kata kunci: IL-10, skor FOUR, COT

scholarly journals AMBARAN FUNGSI MEMORI PADA PASIEN CEDERA KEPALA TRAUMATIK DERAJAT SEDANG DENGAN EDEMA SEREBRI

2018 ◽  
Vol 18 (2) ◽  
pp. 80-85
Author(s):  
Suherman Suherman ◽  
Ipak Nistriana ◽  
Muhammad Rizky
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Function ◽  
Head Injury ◽  
Memory Function ◽  
Healing Process ◽  
Traumatic Head Injury ◽  
Cross Sectional ◽  
Traumatic Head ◽  
Cross Sectional Design

Abstrak. Latar Belakang Cedera kepala traumatik masih menjadi penyebab utama kecacatan dan kematian di dunia. Sebagian besar terjadi pada usia produktif. Efek sekunder dari cedera kepala adalah gangguan fungsi kognitif berupa fungsi memori, visuospasial, perhatian dan konsentrasi, bahasa, kalkulasi, dan orientasi. Masih sedikitnya penelitian tentang penilaian fungsi memori pada pasien cedera kepala di Indonesia. Tujuan Memaparkan gambaran penurunan fungsi kognitif terutama fungsi memori pada pasien cedera kepala derajat sedang dengan edema serebri.Metode Studi deskriptif dengan desain potong-lintang menggunakan kuesioner MMSE dan MoCA-INA sebagai modalitas penilaian.Hasil Dari 30 pasien cedera kepala traumatik derajat sedang didapatkan rerata skor MMSE adalah 27.1±2.13 (interval 20-29). Rerata skor MoCA-INA adalah 24.4±2.99 (interval 16-28). Kedua skor menunjukkan bahwa MoCA-INA memiliki rerata yang lebih rendah dan rentang skor yang lebih luas. Domain yang paling banyak terganggu adalah fungsi memori recall (98%)Kesimpulan Secara keseluruhan pasien dengan cedera kepala traumatik dengan edema serebri mengalami gangguan fungsi memori terutama area memori eksplisit berupa fungsi recall. Tatalaksana kuratif dan rehabilitatif secara adekuat dan berkelanjutan diperlukan untuk mempercepat proses penyembuhanKata Kunci Cedera Kepala Traumatik Derajat Sedang, Fungsi Memori, MMSE, MoCA-INAAbstract. Background Traumatic brain injury is still a major cause of disability and death. Most occur in productive age. Secondary effects of brain injury are impaired cognitive function in the form of memory, visuospatial, attention and concentration, language, calculation, and orientation. There are few research on the assessment of memory function in brain injury patients in Indonesia.Purpose To describes the decreasing cognitive function, particularly memory function in patients with moderate brain injury with cerebral edema.Method Descriptive study with cross-sectional design using MMSE and MoCA-INA questionnaires as assessment modalities.Results Of the 30 patients with moderate-grade traumatic head injury, the mean MMSE score was 27.1 ± 2.13 (intervals 20-29). The average MoCA-INA score is 24.4 ± 2.99 (intervals 16-28). Both scores indicate that the MoCA-INA has a lower mean and a wider score range. The most disturbed domain is recall memory function (96%)Conclusion Overall patients with traumatic brain injury with cerebral edema experience impaired memory function, especially the area of explicit memory in the form of recall function. Adequate and sustainable curative and rehabilitative management is needed to accelerate the healing process Keywords Traumatic Head Injury Moderate Level, Memory Function, MMSE, MoCA-INA 

Symptom Experience and Emotional Distress After Traumatic Brain Injury

2006 ◽  
Vol 7 (1) ◽  
pp. 3-9 ◽  
Author(s):  
Esther Bay ◽  
Karen Bergman
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
San Francisco ◽  
Symptom Management ◽  
Management Strategies ◽  
Outpatient Rehabilitation ◽  
Symptom Experience ◽  
Cross Sectional ◽  
Cross Sectional Design ◽  
Minor Injuries

Traumatic brain injury (TBI) is unexpected and affects nearly 1.5 million Americans annually. Many with seemingly minor injuries incur long-lasting symptoms without clear explanation. This study examined the symptom experience and emotional response of persons with mild-to-moderate TBI and was guided by the University of California San Francisco (UCSF) symptom management model. Using a cross-sectional design with persons recruited from outpatient rehabilitation settings, we found a positive and significant relationship between postinjury symptom frequency and tension/anxiety, anger/hostility and perceived chronic stress, implying a need to understand these relationships over time in order to implement symptom management strategies.

scholarly journals The Community Balance and Mobility Scale: Detecting Impairments in Military Service Members With Mild Traumatic Brain Injury

2019 ◽  
Vol 185 (3-4) ◽  
pp. 428-435
Author(s):  
Marcy M Pape ◽  
Paula N Kodosky ◽  
Peter Hoover
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Mild Traumatic Brain Injury ◽  
Military Service ◽  
Area Under The Curve ◽  
Active Duty ◽  
Service Members ◽  
Cross Sectional ◽  
Cut Score ◽  
Cross Sectional Design

Abstract Introduction The objective of this study was to determine the utility of the Community Balance and Mobility scale (CB&M) among service members presenting with mild traumatic brain injury (mTBI), to compare the results against well-established balance assessments, and to find a new military-specific CB&M cut score to help differentiate those with and without mTBI. Materials and Methods The setting was a 4-week, intensive-outpatient, interdisciplinary program for active duty service members with mTBI. This was a nonrandomized, cross-sectional design that compared multiple measures between two groups: active duty service members with (n = 45) and without (n = 45) mTBI. The assessments, including the Activities-Specific Balance Confidence Scale, gait speed (comfortable and fast), the Functional Gait Assessment, and the CB&M, were provided to both sample groups. Results The mTBI group performed significantly worse (P ≤ 0.01) across all measures. A higher cut score for the CB&M of 81.5 is suggested. The CB&M demonstrated the best sensitivity (78%) and specificity (91%) ratio, as well as the largest effect size and area under the curve(0.92). Conclusion All objective measures distinguish participants with mTBI from controls, ranging from fair to excellent. The recommended CB&M cut score of 81.5 allows for good variance, standard deviation, and reduced risk of ceiling or floor effects. Further examination of the recommended CB&M cut score is warranted for use in the mTBI civilian populations.

Traumatic Brain Injury and Psychopathic Features Among Juvenile Offenders: Does it Matter Which Traits?

2021 ◽  
pp. 0306624X2110492
Author(s):  
Lindamarie Olson ◽  
Michael G. Vaughn
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Juvenile Offenders ◽  
Psychopathic Traits ◽  
Long Term Effects ◽  
Cross Sectional ◽  
Callous Unemotional ◽  
History Of ◽  
The Relationship

Psychopathic traits and a history of traumatic brain injury (TBI) are common among imprisoned individuals. Although previous research has examined correlates of TBI among juvenile offenders, little research has explored the relationship between psychopathic traits and TBI among this population. Study objectives included: (1) examine the association between the history of a TBI and psychopathic traits among juvenile offenders and (2) determine if the history of a TBI predicts the manifestation of different psychopathic factors among juvenile offenders. Cross-sectional data from the Multidimensional Youth Residential Inventory consisted of 226 juvenile offenders. Bivariate and multivariate analyses were conducted. Results of linear regression analyses showed that history of a TBI significantly predicted callous unemotional and impulsive irresponsible traits. Clinical implications suggest early intervention is needed to treat the potential long-term effects of TBIs and the development of psychopathic traits. Recommendations for further research are discussed.

scholarly journals Hubungan Kadar Laminin Serum dengan Klasifikasi CT Marshall dan GCS pada Pasien Cedera Otak akibat Trauma

e-CliniC ◽  
2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Ferry Sudarsono ◽  
Eko Prasetyo ◽  
Maximillian Ch. Oley ◽  
Fima L. F. G. Langi
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Venous Blood ◽  
Elevated Serum ◽  
Cross Sectional ◽  
Coma Scale ◽  
The Difference ◽  
And Gender ◽  
The Individual

 Abstract: Elevated serum laminin levels in patients with traumatic brain injury (TBI) have been documented, but studies on its ability to predict outcomes based on the CT Marshall and Glasgow Coma Scale (GCS) classification are still unclear. This study was aimed to evaluate the relationship between serum laminin levels and Marshall CT as well as GCS classification in COT patients. This was an observational and analytical study with a cross-sectional design. A scan was used to determine the CT Marshall and GCS classification in order to obtain the level of consciousness. Venous blood samples for laminin were drawn less than 24 hours post-trauma. Age and gender were recorded, and the variable selection was carried out gradually. Proportional regression models were used to assess changes in the CT Marshall and GCS classification associated with laminin levels. The result showed that the 32 patients with COT had a mean laminin level of 818.4 pg/mL. Patients were distributed almost uniformly in the six categories of the CT Marshall classification. Furthermore, the final regression model consisted of patients with the CT Marshall IV-VI classification having a serum laminin level of 316.74 pg/mL (95% CI 206.88; 426.60 pg/mL; p<0.001) higher than that of I-III. Meanwhile, after controlling for a number of other variables, the difference increased to 401.06 pg/mL (95% CI 264.84; 563.28 pg/ mL; p<0.001). The individual consciousness levels were measured by using GCS which consist of an inverse relationship with serum laminin levels. Each increase in the mean of GCS rate decreased the laminin value to about 49.10 pg/mL (95% CI 23.33; 74.96 pg/mL; p<0.001). In conclusion, laminin has a significant correlation with the CT Marshall and GCS classifications in patients with COT.Keywords: laminin, traumatic brain injury (TBI)  Abstrak: Peningkatan kadar serum laminin pada pasien dengan cedera otak akibat trauma (COT) telah didokumentasikan, namun studi tentang kemampuannya untuk memrediksi hasil berdasarkan klasifikasi CT Marshall dan GCS (Glasgow Coma Scale) masih terbatas. Penelitian ini bertujuan untuk mengevaluasi hubungan antara kadar laminin serum dengan klasifikasi CT Marshall dan GCS pada pasien COT. Jenis penelitian ialah analitik observasional dengan desain potong lintang. Pemeriksaan CT-scan digunakan untuk menentukan klasifikasi CT Marshall dan GCS digunakan untuk menentukan tingkat kesadaran. Sampel darah vena untuk laminin diambil kurang dari 24 jam pasca trauma. Usia dan jenis kelamin juga dicatat. Seleksi variabel dilakukan secara bertahap. Digunakan model regresi proporsional untuk menilai perubahan klasifikasi CT Marshall dan GCS terkait dengan kadar laminin. Hasil penelitian mendapatkan 32 pasien dengan COT yang masuk ke Instalasi Rawat Darurat Bedah (IRDB). Kadar rerata laminin ialah 818,4 pg/mL. Pasien didistribusikan hampir seragam dalam enam kategori dari klasifikasi CT Marshall. Model regresi akhir terdiri dari penderita dengan klasifikasi CT Marshall IV-VI rata-rata memiliki kadar laminin serum 316,74 pg/mL (95% CI 206,88; 426,60 pg/mL; p<0,001) lebih tinggi daripada mereka dengan kategori I-III. Setelah sejumlah variabel lain dikontrol, selisih tersebut bahkan naik menjadi 401,06 pg/mL (95% CI 264,84; 563,28 pg/mL; p<0,001). Tingkat kesadaran individu, diukur menggunakan GCS, sebaliknya memiliki hubungan terbalik dengan kadar laminin serum. Setiap kenaikan angka GCS rata-rata menurunkan nilai laminin hingga sekitar 49,10 pg/mL (95% CI 23,33; 74,96 pg/mL; p<0,001). Simpulan penelitian ini ialah laminin mempunyai korelasi bermakna dengan klasifikasi CT Marshall dan GCS pada pasien dengan COT.Kata kunci: laminin, cedera otak akibat trauma (COT)

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