LOW LEVELS OF CATHELICIDIN LL-37 SERUM AS RISK FACTORS OF PNEUMONIA ON GERIATRIC PATIENTS IN SANGLAH GENERAL HOSPITAL

TESIS

Abstract

By : Dr.I Putu Denny Mahendra

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Faculties : Fakultas Kedokteran

Department : PS. ILMU PENYAKIT DALAM

Elderly people associated with immune system dysfunction, which is natural immune system play a role in susceptibility to infection. Cathelicidin LL-37 is part of the natural immune system of humans and low levels of cathelicidin LL-37 is risk associated pneumonia in geriatric patients. This study aims to prove the low levels of cathelicidin LL-37 serum as risk factor for pneumonia (community-acquired pneumonia (CAP)) in geriatric patients. The observational studies, case-control studies conducted in inpatient General Hospital Sanglah, Denpasar from June to October 2016. The case group was taken from geriatric patients suffering from CAP and underwent treatment at Sanglah Hospital in Denpasar and control group was taken from the elderly population without CAP living in Panti Werdha Wana Seraya Denpasar and without CAP elderly living in Br. Dauh Puri Klod, Denpasar. Diagnosis of pneumonia based on clinical, laboratory tests and chest X-ray. We used receiver operating characteristic curve (ROC) to determine the cut-off point low levels of cathelicidin LL-37 serum. The relationship between the independent variables (cathelicidin LL-37), the dependent variable (CAP) and the confounding variables (congestive heart failure, chronic kidney disease, DM) was analyzed by bivariate analysis. Multivariate analysis to assess the effect of pure low levels of cathelicidin LL-37 serum as risk factor for CAP. A total of 60 samples included elderly population, consisting of 30 samples of geriatric patients with CAP and 30 elderly without CAP. Determination of cut-off point low levels of cathelicidin LL-37 serum obtained amounted to 91.9 ng / mL. Bivariate analysis showed low levels of cathelicidin LL-37 serum as a risk factor for CAP with OR = 3.59; 95% CI = 1.21 to 10.63 (p = 0.01). On multivariate analysis showed low levels of cathelicidin LL-37 serum and congestive heart failure as a risk factor for CAP with OR 3.89 and 8.44; 95% CI 1.19 to 12.67 and 1.48 to 48 (p = 0.024 and p = 0.016). The results of this study concluded that the low levels of cathelicidin LL-37 serum as risk factor for pneumonia (CAP) in geriatric patients.

Keyword : Elderly, pneumonia, cathelicidin LL-37

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