CD Skripsi

korelasi toll-like receptor 4 (tlr-4) terhadap skor acute physiology and chronic health evaluation ii (apache-ii) dan skor sequential organ failure assessment (sofa) pada pasien sepsis di rsud arifin achmad provinsi riau

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The Correlation of Toll-Like Receptor 4 (TLR-4) on the Acute Physiology and Chronic Health Evaluation II (APACHE II) Score and the Sequential Organ Failure Assessment (SOFA) Score in Sepsis Patients at Arifin Achmad Provincial General Hospital, Riau Province, Indonesia. Supervisors: Novita Anggraeni, Vera Muharrami.
Introduction: Sepsis remains a leading cause of morbidity and mortality in the intensive care unit. The inflammatory response mediated by Toll-like receptor 4 (TLR-4) contributes to multiple organ dysfunction through activation of innate immune pathways, release of proinflammatory cytokines, and progression toward organ failure. Excessive activation of this pathway is suspected to be associated with clinical severity as assessed by the Acute Physiology and Chronic Health Evaluation II (APACHE II) score and the Sequential Organ Failure Assessment (SOFA) score.
Methods: This analytical correlational cross-sectional study was conducted in 39 adult patients with sepsis treated in the intensive care unit (ICU) of RSUD Arifin Achmad, Riau Province, from February to September 2025. Samples were obtained using consecutive sampling according to inclusion and exclusion criteria (age ≥18 years; without cardiogenic shock, without end-stage renal disease, not pregnant). Serum TLR-4 levels were measured using the Enzyme-Linked Immunosorbent Assay (ELISA) method. The APACHE II score was calculated from the worst values within the first 24 hours of treatment, and the SOFA score was calculated at baseline sepsis diagnosis. Data distribution was tested using the Shapiro–Wilk test; because the data were not normally distributed, correlations were analyzed using Spearman’s test.
Results: The mean age of patients was 50 ± 14.1 years, with a Glasgow Coma Scale of 14 (range 3–15). Most of the patients were male (69.2%; 27 of 39), and the most common source of infection was the respiratory tract (51.3%). The median serum TLR-4 level was 1.8 ng/mL (0.18–7.03). The median total APACHE II score was 21 (10–44), and the median total SOFA score was 9 (4–17). There was a significant correlation between TLR-4 and total APACHE II score (r = 0.470; p = 0.003), as well as between TLR-4 and total SOFA score (r = 0.458; p = 0.003), indicating a positive association with illness severity and degree of organ dysfunction. The most consistently correlated components were the electrolyte (potassium) component of APACHE II (r = 0.424; p = 0.007) and the coagulation component of SOFA (r = 0.380; p = 0.017).
Conclusion: Higher serum TLR-4 levels were associated with higher APACHE II and SOFA scores in septic ICU patients. This positive correlation supports the potential role of TLR-4 as a biomarker of disease severity and organ dysfunction in acute sepsis, particularly in the intensive care setting.
Keywords: sepsis; TLR-4; APACHE II; SOFA; inflammatory biomarker; ICU.

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Ketersediaan

Informasi Detail

Judul Seri

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No. Panggil

2110246997

Penerbit

Pekanbaru : UNRI – PASCA – Anestesiologi dan Terapi Intensif., 2025

Deskripsi Fisik

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Bahasa

Indonesia

ISBN/ISSN

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Klasifikasi

2110246997

Tipe Isi

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Tipe Media

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Tipe Pembawa

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Edisi

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Subjek

Anestesiologi dan Terapi Intensif

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Pernyataan Tanggungjawab

Rahmat

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