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Tika Dwi Tama

Abstract

Lebih dari 50% pasien tuberkulosis memiliki indeks massa tubuh (IMT) yang rendah. Rendahnya IMT dapat memperburuk respon pengobatan dan memperbesar risiko gagal pengobatan. Studi kohort retrospektif ini dilakukan untuk mengetahui hubungan IMT dengan konversi sputum pada pasien tuberkulosis paru BTA positif. Studi dilakukan pada Desember 2013- Januari 2014 di poli paru RSUP Persahabatan dengan jumlah sampel sebanyak 120 pasien (60 pasien dengan IMT < 18,5 kg/m2 dan 60 pasien dengan IMT >18,5 kg/m2 ). Sampel diambil secara konsekutif. Probabilitas kumulatif gagal konversi pada pasien tuberkulosis paru BTA positif adalah 17% dan 9,2% pasien mengalami gagal konversi. Pasien tuberkulosis paru BTA positif dengan IMT < 18,5 kg/m2 (24,4%) memiliki probabilitas kumulatif gagal konversi yang lebih besar dibanding pasien dengan IMT > 18,5 kg/m2 (9,3%). Pada pasien dengan IMT < 18,5 kg/m2 , hazard rate konversi sputum semakin rendah jika peningkatan berat badan yang dialami pasien di akhir tahap intensif < 1 kg dibandingkan dengan pasien yang mengalami peningkatan berat badan > 1 kg. Analisis Regresi Cox menunjukkan bahwa IMT < 18,5 kg/m2 menurunkan peluang terjadinya konversi sebesar 37,8% (HR 0,622; 95% CI 0,389-0,995) setelah dikontrol kategori pengobatan, peningkatan berat badan di akhir tahap intensif, dan hasil sputum di awal pengobatan. Status gizi pasien selama pengobatan perlu ditingkatkan untuk menunjang keberhasilan pengobatan.

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