Validitas rasio neutrofil limfosit (RNL) terhadap tipe - tipe histopatologi apendisitis akut = The validity of neutrophil lymphocyte ratio (NLR) on histopatology of types of acute appendicitis

Thorion, Felicia Imanuella (2018) Validitas rasio neutrofil limfosit (RNL) terhadap tipe - tipe histopatologi apendisitis akut = The validity of neutrophil lymphocyte ratio (NLR) on histopatology of types of acute appendicitis. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

Acute appendicitis is one of the the most common cause of acute abdominal pain. However, diagnosing is still challenging with normal appendix still discovered on histopathology results after surgery. NLR is an alternative predictor for acute inflammatory markers to diagnose appendicitis. However, NLR Validity in types of appendicitis are still rarely studied and has limited data in Indonesia. To identify the validity of neutrophil lymphocytes ratio (NLR) according to histopathological type of acute appendicitis. This study used cross sectional method and the sample were acute appendicitis patients in polyclinic and ward of Siloam Hospital Lippo Karawaci during January – December 2017 period with positive histopathology examination for acute appendicitis. Samples were collected from medical record then ROC statistic Curve was used to test data’s specificity and sensitivity. A total of 104 samples were collected which divided into 38 males and 66 female patients. Result showed area under curved ROC 0.706 had a cut-off point NLR <4.1 in catarrhal appendicitis showing 71% and 70% for sensitivity and specificity respectively. In acute suppurative appendicitis, area under curve ROC 0.568 got a cut-off point RNL < 5.8 with 59% sensitivity and 49% specificity. In addition, acute perforated appendicitis showed area under curve ROC 0.780 has a cut-off point > 6.1 with 73% sensitivity and 72% specificity. NLR Validity in acute gangrenous appendicitis not assessed due to lack of sample. To conclude, NLR validity showed high sensitivity and specificity to acute perforated appendicitis followed by acute catarrhal appendicitis and acute suppurative appendicitis / Apendisitis akut merupakan salah satu penyebab tersering nyeri akut abdomen. Namun diagnosisnya masih menjadi tantangan dengan ditemukannya hasil histopatologi apendiks normal setelah operasi. Rasio Neutrofil Limfosit (RNL) merupakan pemeriksaan alternatif untuk mendeteksi tanda inflamasi akut pada apendisitis. Namun demikian, validitas RNL untuk tipe - tipe apendisitis akut belum banyak diteliti dan memiliki data yang terbatas di Indonesia. Mengetahui validitas rasio neutrofil limfosit (RNL) pada tipe apendisitis menurut pemeriksaan histopatologi. Penelitian ini menggunakan metode studi potong lintang dengan mengambil sampel pasien apendisitis akut di poliklinik dan bangsal RS Siloam Lippo Karawaci periode Januari – Desember 2017 dengan hasil histopatologi positif apendisitis akut. Pada rekam medis dilakukan pengambilan data pasien mengenai RNL dan histopatologi, kemudian data tersebut dianalisis menggunakan statistik kurva ROC, uji sensitifitas dan uji spesifisitas. Diperoleh 104 sampel dengan 38 pasien laki-laki dan 66 pasien perempuan. Area under curve ROC 0,706 didapatkan cut off RNL < 4,1 pada acute catarrhal appendicitis dengan nilai sensitivitas 71% dan spesifisitas 70%. Pada acute suppurative appendicitis, area under curve ROC 0,568 didapatkan cut off RNL < 5,8 dengan nilai sensitivitas 59% dan spesifisitas 49%. Serta pada acute perforated appendicitis dengan area under curve ROC 0,780 didapatkan cut off > 6,1 dengan nilai sensitivitas 73% dan spesifisitas 72%. Validitas RNL pada acute gangrenous appendicitis tidak dilakukan karena jumlah sampel yang tidak cukup. Dapat disimpulkan bahwa, validitas RNL menunjukan sensitivitas dan spesifisitas tertinggi pada acute perforated appendicitis diikuti acute catarrhal appendicitis dan acute suppurative appendicitis.

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