GAMBARAN INDEKS BARTHEL PADA PASIEN STROKE DENGAN LEUKOSITOSIS DI RSUD ARIFIN ACHMAD PROVINSI
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2014-02-25
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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
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Keywords
Stroke, Leukocytosis, Activity of Daily Living, ADL, Barthel Index