Artikel PDF

Galuh Hardaningsih, Tjipta Bahtera

ABSTRACT

Background:Convulsive status epilepticus (CSE) is the most common childhood medical neurological emergencies, and is associated with significant morbidity and mortality. Clinico-epidemiologic characteristics and etiology of children with seizure have been emphasized as risk factors for CSE. Objective: To define the role of body temperature at onset of seizure, duration of seizure, central nervous system (CNS) infection, metabolic disorder, increased intracranial pressure, sepsis, anemia and moderate malnutrition as a predictor of CSE.

Methods: The medical records of children aged between six months and 5 years with the diagnosis of CSE who were admitted to Kariadi Hospital from anuary 1st 2007 to December 31st2012 were retrospectively reviewed. In this case control study involved 80 children with CSE. Risk factors were analyzed with an odds ratio (95% confidence interval (CI)) and discriminant analysis.

Results: The mean age of subjects in the case group 17.46 (SD 1.72) and in the control group 17.74 (SD 1.73) months (p > 0.05). Duration of seizure  (OR 4.74; 95%CI 2.41-9.33), temperature at onset of seizure (OR 2.5; 95%CI 1.32-4.72), CNS infection (OR 4.36; 95%CI 2.24-8.47), metabolic disorder (OR 2.18; 95%CI 1.09-4.35), increased intracranial pressure (OR 2.63; 95%CI 1.33-5.17), sepsis (OR 2.51; 95%CI 1.33-4.76), anemia (OR 3; 95%CI 1.54-5,86) and moderate malnutrition (OR 2.14; 95%CI 1.08-4.23) were risk factors for CSE in children with seizure (p<0.05). Multivariate discriminant analysis showed that the probability of had a child with those risk factors for developing into CSE was 73%.

Conclusion: Duration of seizure, temperature at onset of seizure, CNS infection, metabolic disorder, increased intracranial pressure, sepsis, anemia and moderate malnutrition are risk factors for CSE which can be used as a predictor of CSE in children with seizure.

Keywords: Convulsive status epilepticus, a risk factor

ABSTRAK

Latar belakang: Status epileptikus konvulsivus (SEK) merupakan kegawatdaruratan neurologis pada anak dengan morbiditas dan mortalitas yang tinggi. Karakteristik klinis epidemiologi dan etiologi pada anak dengan kejang telah diketahui berperan sebagai faktor risiko bangkitan SEK. Tujuan: Membuktikan peran faktor suhu tubuh saat onset kejang, durasi kejang, infeksi susunan saraf pusat (SSP), gangguan metabolik, tekanan intrakranial meningkat, sepsis, anemia dan status gizi kurang sebagai prediktor timbulnya bangkitan SEK.

Metode: Penelitian restrospektif ini berdasarkan data catatan medis anak usia 6 bulan – 5 tahun dengan diagnosis SEK yang dirawat di RSUP Dr.Kariadi selama periode 1 Januari 2007–31 Desember 2012. Penelitian menggunakan design case control yang melibatkan 80 anak dengan SEK. Faktor-faktor risiko dianalisis dengan ratio odds (95% interval kepercayaan (IK)) dan analisis diskriminan.

Hasil: Subyek penelitian pada kelompok kasus dengan SEK dan kontrol masing-masing terdiri atas 80 anak. Rerata umur subyek pada kelompok kasus 17,46 (SD 1,72) bulan dan pada kelompok kontrol 17,74 (SD 1,73) bulan (p > 0,05). Durasi kejang (OR 4,74; 95%IK 2,41–9,33), suhu tubuh saat onset kejang (OR 2,5; 95%IK 1,32–4,72), infeksi SSP (OR 4,36; 95%IK 2,24–8,47), gangguan metabolik (OR 2,18; 95%IK 1,09–4,35), tekanan intrakranial meningkat (OR 2,63; 95%IK 1,33–5,17), sepsis (OR 2,51; 95%IK 1,33–4,76)), anemia (OR 3; 95%IK 1,54–5,86) dan gizi kurang (OR 2,14; 95%IK 1,08–4,23) merupakan faktor-faktor risiko SEK pada anak dengan kejang. Analisis multivariate diskriminan menunjukkan probabilitas anak dengan faktor-faktor risiko tersebut untuk mengalami SEK adalah sebesar 73%.

Leave a Reply