Fraktur Nasal sebagai Faktor Prediktor Terjadinya Lesi Intrakranial dan Derajat Keparahan Cedera Kepala di RSUP Prof. Ngoerah Denpasar: Nasal Fracture as a Predictor of Intracranial Lesions and Head Injury Severity

Salomo Mahaputra Messakh; I Wayan Periadijaya; I Made Mulyawan

doi:10.35473/jhhs.v8i2.766

Authors

Salomo Mahaputra Messakh Universitas Udayana
I Wayan Periadijaya Universitas Udayana
I Made Mulyawan Universitas Udayana

DOI:

https://doi.org/10.35473/jhhs.v8i2.766

Keywords:

Head Injury, Nasal Fracture, Intracranial Lesion, Predictor

Abstract

Nasal fracture is the third most common facial fracture globally and carries a risk of head injury and intracranial lesions, yet incidence data in Bali remain limited. To assess nasal fracture as a predictor of intracranial lesions and head injury severity at Prof. Dr. I.G.N.G. Ngoerah General Hospital, Denpasar. A retrospective cross-sectional study reviewed medical records of adult patients (>18 years) treated from January 2021 to December 2023. Seventy-one patients were selected by consecutive sampling based on completeness of CT-scan and initial GCS data; associations were analyzed using bivariate and multivariate tests (SPSS v.25; α=0.05). Nasal fracture was found in 42 patients (59.2%); intracranial lesions in 35 patients (49.3%) and moderate-severe injury (GCS ≤12) in 41 patients (57.7%). Multivariate analysis identified age >40 years (aOR 5.18; 95%CI 1.35–19.77; p=0.016) and nasal fracture (aOR 7.12; 95%CI 2.22–22.81; p=0.001) as independent predictors of intracranial lesions; nasal fracture also independently predicted moderate-severe injury (aOR 6.01; 95%CI 2.03–17.78; p=0.001).: Nasal fracture is an independent predictor of intracranial lesions and moderate-severe head injury, and may serve as an early clinical marker in craniofacial trauma triage.

ABSTRAK

Fraktur nasal merupakan fraktur tulang wajah paling umum ketiga secara global dan berisiko menimbulkan cedera kepala serta lesi intrakranial, namun data insidennya di Bali masih terbatas. Menilai fraktur nasal sebagai prediktor lesi intrakranial dan derajat keparahan cedera kepala di RSUP Prof. Dr. I.G.N.G. Ngoerah, Denpasar. Studi potong lintang retrospektif dilaksanakan melalui penelusuran rekam medis pasien dewasa (>18 tahun) yang dirawat pada Januari 2021–Desember 2023. Sebanyak 71 pasien dipilih secara consecutive sampling berdasarkan kelengkapan data CT-scan dan skor GCS awal; hubungan fraktur nasal dengan lesi intrakranial dan keparahan cedera dianalisis menggunakan uji Chi-Square dan regresi logistik biner (SPSS v.25; α=0,05). Fraktur nasal ditemukan pada 42 pasien (59,2%); lesi intrakranial pada 35 pasien (49,3%) dan cedera sedang-berat (GCS ≤12) pada 41 pasien (57,7%). Analisis multivariat menunjukkan usia >40 tahun (aOR 5,18; 95%CI 1,35–19,77; p=0,016) dan fraktur nasal (aOR 7,12; 95%CI 2,22–22,81; p=0,001) sebagai prediktor independen lesi intrakranial; fraktur nasal juga menjadi prediktor independen cedera sedang-berat (aOR 6,01; 95%CI 2,03–17,78; p=0,001). Fraktur nasal merupakan prediktor independen lesi intrakranial dan keparahan cedera kepala sedang-berat, sehingga dapat dipertimbangkan sebagai penanda klinis awal dalam triase pasien trauma kraniofasial.

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