ASSOCIATION BETWEEN LOWER PLATELET-TO-LYMPHOCYTE RATIO AND MORTALITY RISK IN MODERATE-TO-SEVERE TRAUMATIC BRAIN INJURY : A RETROSPECTIVE COHORT STUDY
DOI:
https://doi.org/10.31004/prepotif.v9i2.46775Keywords:
cedera otak traumatic, limfosit, rasio trombosit terhadap limfosit, risiko kematian, trombositAbstract
Penelitian ini menyelidiki hubungan antara rasio trombosit terhadap limfosit dan risiko kematian pada pasien dewasa dengan COT sedang hingga berat di rumah sakit tersier di Indonesia. Sistem registrasi rumah sakit dikaji secara retrospektif untuk mengumpulkan rekam medis dari 77 pasien dewasa yang menjalani rawat inap dari 1 Juni 2024 hingga 31 Desember 2024 dan didiagnosis dengan COT sedang hingga berat. Rasio neutrofil terhadap limfosit (NLR) serta rasio trombosit terhadap limfosit (PLR) dibandingkan antara kelompok pasien yang bertahan hidup (n=59) dan yang tidak bertahan hidup (n=18). Kemampuan prediktif NLR dan PLR dianalisis menggunakan area di bawah kurva karakteristik operasi penerima (AUC). Analisis tabel kontingensi dilakukan untuk menentukan sensitivitas, spesifisitas, nilai prediksi positif (PPV), nilai prediksi negatif (NPV), akurasi, serta rasio odds (OR) dari NLR dan PLR dalam kaitannya dengan tingkat kematian. Variasi kelangsungan hidup di antara subkelompok PLR dievaluasi melalui analisis kelangsungan hidup Kaplan-Meier. PLR pada pasien yang meninggal secara signifikan lebih rendah dibandingkan dengan kelompok yang bertahan hidup (nilai p = 0,026). Kurva ROC menunjukkan bahwa PLR merupakan prediktor terkuat dibandingkan dengan kedua rasio lainnya (area di bawah kurva ROC = 0,674, sensitivitas = 0,874, spesifisitas = 0,56, sesuai dengan nilai batas = 120,09). Ketika kelompok pasien dibagi berdasarkan kuartil PLR, analisis Kaplan-Meier menunjukkan kelangsungan hidup yang jauh lebih buruk pada kelompok dengan kuartil PLR terendah (< 120,09) dibandingkan dengan kelompok kuartil lainnya. Nilai PLR yang lebih rendah dikaitkan dengan tingkat kematian yang lebih tinggi pada pasien dewasa dengan COT sedang hingga berat, menunjukkan potensi penggunaan PLR dalam stratifikasi risiko yang memerlukan validasi lebih lanjut.References
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