GAMBARAN INDEKS BARTHEL PADA PASIEN STROKE DENGAN LEUKOSITOSIS DI RSUD ARIFIN ACHMAD PROVINSI

Abstract

The Barthel Index currently being used by general practices, neurologists, and other medical division to assess progress and prospect of rehabilitation for patients with disability. Stroke patients especially with apparent neurological deficit post stroke were taken to rehabilitation phase supervised by medical rehab practice as soon as they declared stable by authorized doctor. The definition of stable itself are vary, from appropriate scores of Glasgow Coma Scale (GCS), cooperativeness, or sometimes by clinical judgement by authorized doctor. The clinical judgement includes consideration of the general state of patients, like, as in this research focusing, inflamation. Inflamation as a natural response for threat inside the human body e.g bacteria & viral infection, foreign bodies, etc. often occured in stroke patients, characterized by high body temperatures and elevated white blood cell/ leukocyte count, defined as leukocytosis. Some study has been assigned to analyzed that state, since stroke patients with leukocytosis at onset often had a worse prognosis than others; mostly death. It has been suspected that leukocyte activities as phagocyte are responsible to broke tissues around them, as in stroke particularly hemoragic stroke the blood clot that sits around brain tissue worsening the injury; evident by CT Scan in some study that lession volume are wider in stroke patients with leukocytosis. The purpose of this research is to measures whether leukocytosis did worsening the brain injury suffered by all stroke survivors thus resulting in poorer neurological deficit, affecting their activity of daily living (ADL). ADL in this research measured by Barthel Index, consisting of ten simple tasks that represents basic activity of daily living e.g independency of bathing, grooming, feeding and other motoric activity. The results are from 35 qualified patients whose dominantly characterized by men, aged above 50 years old and leukocytes above 10.000/uL, 13 patients (37,15 %) were in total dependency (Barthel index 0-20), 8 (22,86 %) were in severe dependency (Barthel index 25-40), 4 (11,42 %) in mild dependency (Barthel index 45-55), 9 (25,71 %) in light dependency (Barthel index 60-95) and only 1 patient declared independent. Conclusion more than half of subjects are categorized as poor impairment in terms of ADL and only one survivor are declared independent after hospitalized. Keywords: Stroke, Leukocytosis, Activity of Daily Living, ADL, Barthel Index