Gambaran Kualitas Hidup Pasien Pasca Trauma Kepala Sedang dan Berat dengan Lesi Intrakranial Menggunakan Parameter EUROQOL Group EQ-5D-5L di Departemen Bedah Saraf Rumah Sakit Hasan Sadikin Bandung

Abstract

Background: Head injury is one of the main causes of death in motor vehicle users in developing countries. The mortality rate of post-traumatic head patients during hospitalization is quite high. The literature on the quality of life of patients post traumatic brain injury (TBI) or neurological patients in developing countries is very limited data.

Objective:  Assess the quality of  life in  moderate and  severe head  trauma  patients with intracranial lesions at Hasan Sadikin Bandung Hospotal using the EQ-5D-5L questionnaire.

Methods: This study used a prospective descriptive observational research design with a cross sectional  study  design,  with  subjects  being neurosurgical  patients  entering  the  hospital emergency  room.  Hasan  Sadikin  Hospital  Hand  fulfilling  the  inclusion  criteria  will  be performed an initial examination by a neurosurgeon, then proceed with filling in the F1 questionnaire, as long as the treatment will fill in F2, and before returning home to fill in F3, then follow up for months 1, 2, and 3 will fill in the F4 format. 1, F4.2 and F4.3. Samples were taken by consecutive sampling.

Result: There were 721 head trauma patients who entered the Emergency Department (IGD) of the neurosurgery section of Hasan Sadikin Hospital (RSHS) in the period August 1, 2018 up to January 31, 2019, found 22 (3.05%) people died in the emergency room, 23 people (3.2%) were forced to go home before being interviewed, and 36 patients (4.5%) were included in the inclusion criteria and participated in this study. Based on the dimensions of the EQ-5D mobilization when going home there were no problems of 35%, a slight problem of 62%, and a moderate problem of 3%. The scale of self-care is found without a problem of 10%, a slight problem of 87%, and a moderate problem of 3%. The usual scale of activities found without problem as much as 3%, a slight problem 87%, and a moderate problem 10%. The pain scale was obtained when returning home there were no problems as much as 10%, the problem was a little 83%, and the problem was 7%. Anxiety / depression scale was there were no problems as much as 52%, a slight problem 45%, and a moderate problem 3%. Intellectual scale was found there were no problems of 74%, a slight problem of 23%, and a moderate problem of 3%.

Conclusion: There were improvements on all dimensions of the Euroqol EQ-5D at the end of monitoring.

Latar Belakang : Trauma kepala merupakan salah satu penyebab utama kematian pada pengguna kendaraan bermotor di negara berkembang. Angka kematian pasien pasca trauma kepala saat perawatan di rumah sakit cukup tinggi. Literatur tentang kualitas hidup pasien pasca trauma kepala atau pasien neurologis di negara berkembang sangat terbatas.

Tujuan: Menilai kualitas hidup pasien trauma kepala sedang dan berat dengan lesi intrakranial di bagian Bedah Saraf RS. Hasan Sadikin Bandung menggunakan kuisioner EQ-5D-5L.

Metode : Penelitian ini menggunakan desain penelitian observasional deksriptif prospektif, dengan subjek penelitian pasien bedah saraf yang masuk ke ruang gawat darurat RS. Hasan Sadikin dan memenuhi kriteria inklusi. Dilakukan pemeriksaan awal oleh dokter bedah saraf dan dilakukan pemeriksaan CT-Scan, kemudian dilanjutkan dengan mengisi kuisioner F1, selama perawatan akan mengisi F2, dan sebelum pulang mengisi F3, selanjutnya follow-up selama bulan 1, 2, dan 3 akan mengisi format F4.1, F4.2 dan F4.3. Sampel diambil dengan cara Consecutive Sampling.

Hasil : Dari 721 pasien trauma kepala yang masuk ke Instalasi Gawat Darurat (IGD) bagian bedah saraf   Rumah Sakit Hasan Sadikin (RSHS) selama periode 1 Agustus 2018 sampai dengan 31 Januari 2019, didapatkan 22 (3,05 %) orang meninggal di IGD, 23 orang (3,2 %) pulang paksa sebelum dilakukan interview, dan diperoleh 36 pasien (4,5 %) yang masuk kriteria inklusi dan ikut dalam penelitian ini. Berdasarkan skala dimensi Euroqol EQ-5D mobilisasi saat pulang tidak ada masalah sebanyak 35%, sedikit masalah 62 %, dan masalah sedang 3 %. Skala perawatan diri didapatkan pasien yang saat pulang tidak ada masalah sebanyak 10%, sedikit masalah 87 %, dan masalah sedang 3 %. Skala aktifitas biasa didapatkan pada saat pulang tidak ada masalah sebanyak 3%, sedikit masalah  87 %, dan masalah sedang 10 %. Skala nyeri didapatkan pada saat pulang tidak ada masalah sebanyak 10%, masalah sedikit  83%, dan masalah sedang 7%.  Skala kecemasan / depresi  didapatkan pada saat pulang tidak ada masalah sebanyak 52%, sedikit masalah  45%, dan masalah sedang 3%. Skala intelektual didapatkan pada saat pulang tidak ada masalah sebanyak 74%, sedikit masalah  23%, dan masalah sedang 3%.

Kesimpulan  : Kuesioner  Euroqol  EQ-5D  merupakan  instrumen  yang  mudah  dimengerti,  tidak membutuhkan biaya banyak serta dapat diterapkan di berbagai bidang ilmu. Terdapat perbaikan pada semua skala dimensi Euroqol EQ-5D pada akhir pemantauan.