ABSTRACT FORMAT

Author : dr. Luwinda Avitha Sari Harahap

Co-Author : 1. dr. Rusli Dhanu, Sp.S (K)
2. dr. Puji Pinta Sinurat, Sp.S
Category abstract : Stroke
Address : Jalan Pendidikan no. 97 Medan Kel.Indra Kasih Kec.Medan tembung
Kodepos : 20221
Institution : Departemen Neurologi Fakultas Kedokteran Universitas Sumatera
Utara (USU) / RSUP Haji Adam Malik Medan
Phone Number : 081397543014
E-Mail : lulusupergirly2@gmail.com atau luluandri4@gmail.com

Judul : PERBANDINGAN TINGKAT AKURASI DIAGNOSTIK ANTARA

INTRAVENTRICULAR HEMORRHAGE SCORE (IVH SCORE /
IVHS), MODIFIED GRAEB SCORE (mGS), DAN LeRoux
SCORE UNTUK MENILAI OUTCOME STROKE
HEMORAGIK

Penelitian ini masih berlangsung sampai JULI 2015 (On Going). Saya akan mengirimkan
makalah finalnya sebelum batas waktu yang ditentukan oleh Panitia. Sekian dan Terimakasih
atas perhatiannya.
 PERBANDINGAN TINGKAT AKURASI DIAGNOSTIK ANTARA
INTRAVENTRICULAR HEMORRHAGE SCORE (IVH SCORE / IVHS), MODIFIED
GRAEB SCORE (mGS), DAN LeRoux SCORE UNTUK MENILAI OUTCOME
STROKE HEMORAGIK

Luwinda Avitha Sari Harahap1), Rusli Dhanu2), Puji Pinta Sinurat3)

1) Residen Departemen Neurologi FK USU / RSUP Haji Adam Malik Medan, Sumatera Utara
2) Staff Departemen Neurologi FK USU / RSUP Haji Adam Malik Medan, Sumatera Utara
3) Staff Departemen Neurologi FK USU / RSUP Haji Adam Malik Medan, Sumatera Utara

ABSTRAK

Latar Belakang dan Tujuan :

Metode klinis untuk menilai perdarahan intraventrikular belum dikenal dengan baik hingga
saat ini. Penilaian terhadap volume IVH (Intraventricular Hemorrhage) yang dapat
dipercaya, sederhana, cepat, dan bermakna secara klinis sangat diperlukan tidak hanya untuk
percobaan klinis, tetapi juga dapat digunakan sebagian besar dalam praktek klinis.
Intraventricular Hemorrhage Score (IVH Score / IVHS), Modified Graeb Score (mGS), dan
LeRoux Score dikembangkan untuk menilai keparahan IVH berdasarkan ukuran besarnya
perdarahan dan adanya dilatasi didalam setiap ventrikel. Penelitian ini bertujuan untuk
menentukan IVH grading scale yang terbaik dengan mengevaluasi prediksi akurasi
diagnostik dari Intraventricular Hemorrhage Score (IVH Score / IVHS), Modified Graeb
Score (mGS), dan LeRoux Score dalam menilai outcome stroke hemoragik.

Metode :
Penelitian ini merupakan studi potong lintang yang dilakukan terhadap 49 orang pasien stroke
hemoragik yang dirawat inap di RSUP Haji Adam Malik Medan. Pasien yang termasuk ke
dalam kriteria inklusi penelitian ini adalah semua pasien stroke hemoragik yang harus
dijumpai perdarahan intraventrikular, bisa dalam bentuk perdarahan intraventrikular primer
ataupun sekunder. Semua pasien tersebut akan dievaluasi dengan menggunakan
Intraventricular Hemorrhage Score (IVH Score / IVHS), Modified Graeb Score (mGS), dan
LeRoux Score pada saat datang ke RSUP Haji Adam Malik Medan. Outcome stroke
hemoragik dinilai dengan menggunakan Modified Rankin Scale (mRS). Outcome buruk
ditandai dengan nilai skor mRS >3.

Hasil :
Nilai AUC (Area Under Curve) untuk Intraventricular Hemorrhage Score (IVH Score /
IVHS) adalah 0,838 (95%CI 0,721-0,954), Modified Graeb Score (mGS) adalah 0,810
(95%CI 0,676-0,943), dan LeRoux Score adalah 0,817 (95%CI 0,695-0,939). Nilai
sensitivitas dan spesifisitas Intraventricular Hemorrhage Score (IVH Score / IVHS) untuk
memprediksi outcome buruk (mRS>3) pada stroke hemoragik adalah 82,5% dan 77,8%,
dengan titik potong optimal (optimal cut off point) adalah 8,5. Nilai sensitivitas dan
spesifisitas Modified Graeb Score (mGS) untuk memprediksi outcome buruk (mRS>3) pada
stroke hemoragik adalah 77,5% dan 77,8%, dengan titik potong optimal (optimal cut off
point) adalah 8,5. Nilai sensitivitas dan spesifisitas LeRoux Score untuk memprediksi
outcome buruk (mRS>3) pada stroke hemoragik adalah 75% dan 66,7%, dengan titik potong
optimal (optimal cut off point) adalah 4,5. Terdapat hubungan yang signifikan antara
Intraventricular Hemorrhage Score (IVH Score / IVHS), Modified Graeb Score (mGS), dan
LeRoux Score dengan outcome stroke hemoragik (p<0,005).
Kesimpulan :
Intraventricular Hemorrhage Score (IVH Score / IVHS), Modified Graeb Score (mGS), dan
LeRoux Score memiliki tingkat akurasi diagnostik yang sama sama baik untuk menilai
outcome stroke hemoragik.

Kata kunci :
Intraventricular Hemorrhage Score, IVH Score, IVHS, Modified Graeb Score, mGS, LeRoux
Score, outcome stroke hemoragik, IVH, Intraventricular Hemorrhage, perdarahan
intraventrikular, Modified Rankin Scale, mRS, keparahan IVH, IVH grading scale

COMPARISON OF THE DIAGNOSTIC ACCURACY OF THE

INTRAVENTRICULAR HEMORRHAGE SCORE ( IVH SCORE or IVHS ),
 MODIFIED GRAEB SCORE (mGS), AND LeRoux SCORE FOR EVALUATION OF
OUTCOME HEMORRHAGIC STROKE

Luwinda Avitha Sari Harahap1), Rusli Dhanu2), Puji Pinta Sinurat3)

1)
Resident of Neurology Department, Faculty of Medicine, North Sumatra University/H. Adam Malik
Hospital, Medan
2)
Staff of Neurology Department, Faculty of Medicine, North Sumatra University/H. Adam Malik
Hospital, Medan
3)
Staff of Neurology Department, Faculty of Medicine, North Sumatra University/H. Adam Malik
Hospital, Medan
ABSTRACT

Background and Purpose :

Clinical methods for evaluating intraventricular hemorrhage, until now, are not well
established. Evaluation for IVH (intraventricular hemorrhage) volume that can be reliable,
simple, quick, and clinically meaningful approximation of IVH volume is needed not only for
clinical trials, but also clinical practice more widely Intraventricular Hemorrhage Score (IVH
Score or IVHS), Modified Graeb Score (mGS), and LeRoux Score were developed to
estimate IVH severity based on gross hemorrhage size and the presence of dilation within
each ventricle. The aim of this study is to determine the best IVH grading scale by evaluating
the predictive diagnostic accuracies of the Intraventricular Hemorrhage Score (IVH Score or
IVHS), Modified Graeb Score (mGS), and LeRoux Score in evaluating outcome of the
hemorrhagic stroke.

Objective :
The objective of this study was to compare the diagnostic accuracy of the Intraventricular
Hemorrhage Score (IVH Score or IVHS), Modified Graeb Score (mGS), and LeRoux Score
for evaluation outcome of the hemorrhagic stroke.

Methods :
This was a cross sectional study of 49 hemorrhagic stroke patients that are taken care in
Adam Malik General Hospital. Patients that can be included in inclusion criteria this study is
all of hemorrhagic stroke patients that must be found intraventricular hemorrhage, can be
form primary or secondary intraventricular hemorrhage.All of patients will be evaluation with
using the Intraventricular Hemorrhage Score (IVH Score or IVHS), Modified Graeb Score
(mGS), and LeRoux Score when they come to Adam Malik General Hospital. Outcome of
the hemorrhagic stroke are evaluated with using Modified Rankin Scale (mRS). Poor
outcome was defined as mRS scores > 3.

Results :
Area Under Curve (AUC) value of the Intraventricular Hemorrhage Score (IVH Score or
IVHS) was 0,838 (95%CI 0,721-0,954), Modified Graeb Score (mGS) was 0,810 (95%CI
0,676-0,943), and LeRoux Score was 0,817 (95%CI 0,695-0,939). Sensitivity and specificity
value of the Intraventricular Hemorrhage Score (IVH Score or IVHS) for predicted poor
outcome (mRS>3) of the hemorrhagic stroke was 77,5% and 77,8%, with optimal cut off
point was 8,5. Sensitivity and specificity value of Modified Graeb Score (mGS) the for
predicted poor outcome (mRS>3)of the hemorrhagic stroke was 77,5% and 77,8%, with
optimal cut off point was 8,5. Sensitivity and specificity value of the LeRoux Score for
predicted poor outcome (mRS>3) of the hemorrhagic stroke was 75% dan 66,7%, with
optimal cut off point was 4,5. Intraventricular Hemorrhage Score (IVH Score or IVHS),
Modified Graeb Score (mGS), and LeRoux Score have significantly relationship with
outcome of the hemorrhagic stroke (p<0,005)

Conclusion :
Intraventricular Hemorrhage Score (IVH Score or IVHS), Modified Graeb Score (mGS), and
LeRoux Score have similarly good diagnostic accuracy for predicting outcome of the
hemorrhagic stroke.

Key Words :
Intraventricular Hemorrhage Score, IVH Score, IVHS, Modified Graeb Score, mGS, LeRoux
Score, outcome of the hemorrhagic stroke, IVH, Intraventricular Hemorrhage, Modified
Rankin Scale, mRS, IVH severity, IVH grading scale