Relationship of acid–base imbalance with hemorrhage volume and mortality in intracerebral stroke hemorrhage

Gavin Mukti; Iwan Setiawan; Metana Puspitasari; Sulistyani Sulistyani

doi:10.31101/jhes.4008

Authors

Gavin Mukti Universitas Muhammadiyah Surakarta
Iwan Setiawan Universitas Muhammadiyah Surakarta
Metana Puspitasari Universitas Muhammadiyah Surakarta
Sulistyani Sulistyani Universitas Muhammadiyah Surakarta

DOI:

https://doi.org/10.31101/jhes.4008
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Keywords:

acid-base disorders, intracerebral hemorrhage volume, mortality, hemorrhagic stroke

Abstract

This study aimed to evaluate the relationship between acid-base balance disturbances and intracerebral hemorrhage volume with mortality rates in hemorrhagic stroke cases. The research used an observational analytic design with a cross-sectional approach and was conducted at Dr. Soeratno Gemolong General Hospital, Sragen, from September to November 2024. The study population consisted of medical records of patients diagnosed with hemorrhagic stroke at the hospital between August 2021 and August 2024 who met the inclusion criteria. A total of 50 samples were selected using a purposive sampling technique. Data analysis included univariate analysis, bivariate analysis using the Chi-Square test, and multivariate analysis using logistic regression. The results showed a significant relationship between acid–base balance disturbances and intracerebral hemorrhage volume with mortality in hemorrhagic stroke cases (p=0.001). In addition, intracerebral hemorrhage volume was significantly associated with mortality (p=0.007). Multivariate analysis confirmed that both acid–base imbalance and hemorrhage volume significantly influence mortality outcomes. These findings indicate that acid–base imbalance and intracerebral hemorrhage volume greater than 30 ml are strong predictors of mortality in hemorrhagic stroke patients. Therefore, strict monitoring of arterial blood gases, neurological status, and hemodynamic stability is essential during the acute phase of care. Early detection of physiological deterioration and prompt intervention may help reduce the risk of adverse outcomes. Future research is recommended to use prospective multicenter designs with larger sample sizes to further clarify causal relationships and evaluate whether early correction of acid–base disturbances can improve mortality outcomes in hemorrhagic stroke patients.

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References

Atypical, T. S. (2016). Global cerebral edema from hypercapnic respiratory acidosis. 1556–1558.

Aulia, N. N., Syifak, S., & Yuniati, D. (2023). Analysis of Factors Influencing Mortality in Patients with Intracerebral Hemorrhagic Stroke. Jurnal Ilmiah Kedokteran Wijaya Kusuma, 12(2), 124. https://doi.org/10.30742/jikw.v12i2.2880

Awanis, M., Marwan Sikumbang, K., & Asnawati, A. (2021). Korelasi antara Skor Intracerebral Hemorrhage (ICH) dengan Mortalitas Pasien Perdarahan Intraserebral di RSUD Ulin Banjarmasin. Jurnal Neuroanestesi Indonesia, 10(1), 1–7. https://doi.org/10.24244/jni.v10i1.266

Ayundari. (2021). Diagnosis Dan Tatalaksana Stroke Hemoragik. Jurnal Medika Hutama, 03(01), 402–406.

Azizah, A. N., & Arofiati, F. (2023). Pengaruh Pemberian Elevasi Kepala 30° Terhadap Peningkatan Saturasi Oksigen Pada Pasien dengan Stroke Non Hemoragik. Dinamika Kesehatan: Jurnal Kebidanan Dan Keperawatan, 14(1), 81–89. https://doi.org/10.33859/dksm.v14i1.889

Greenberg, S. M., Ziai, W. C., Cordonnier, C., Dowlatshahi, D., Francis, B., Goldstein, J. N., Hemphill, J. C., Johnson, R., Keigher, K. M., Mack, W. J., Mocco, J., Newton, E. J., Ruff, I. M., Sansing, L. H., Schulman, S., Selim, M. H., Sheth, K. N., Sprigg, N., & Sunnerhagen, K. S. (2022). 2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association. In Stroke (Vol. 53, Issue 7). https://doi.org/10.1161/STR.0000000000000407

Jahan, N. (2016). Effectiveness of Lower Extremity Mirror Therapy on Balance and Gait for Post Stroke Patients.

Nindrea, R. D., & Hasanuddin, A. (2023). Non-modifiable and modifiable factors contributing to recurrent stroke: A systematic review and meta-analysis. Clinical Epidemiology and Global Health, 20(December 2022), 101240. https://doi.org/10.1016/j.cegh.2023.101240

Park, J. H., Lee, J., Kwon, S. U., Kwon, H. S., Lee, M. H., & Kang, D. W. (2022). Elevated Pulse Pressure and Recurrent Hemorrhagic Stroke Risk in Stroke With Cerebral Microbleeds or Intracerebral Hemorrhage. Journal of the American Heart Association, 11(3). https://doi.org/10.1161/JAHA.121.022317

Rangamani, S., Huliyappa, D., Kulothungan, V., Saravanan, S., Murugan, P. K., Mahadevan, R., Rachel Packiaseeli, C., Bobby, E., Sunitha, K., Mallick, A. K., Nayak, S. D., Swain, S. K., Behera, M., Nath, B. K., Swami, A., Kalwar, A. K., Difoesa, B., Sardana, V., Maheshwari, D., … Mathur, P. (2024). Stroke incidence, mortality, subtypes in rural and urban populations in five geographic areas of India (2018–2019): results from the National Stroke Registry Programme. The Lancet Regional Health - Southeast Asia, 23, 100308. https://doi.org/10.1016/j.lansea.2023.100308

Riasmini, N. M., Hartini, T., Resnayati, Y., & ... (2024). Determinant Factors of Family Behavior in Stroke Prevention in the Elderly. … on Health Research …, 11–21. https://www.poltekkesjakarta3.ac.id/ejurnalnew/index.php/ProsidingJKT3/article/view/1833

Schrag, M., & Kirshner, H. (2020). Management of Intracerebral Hemorrhage: JACC Focus Seminar. Journal of the American College of Cardiology, 75(15), 1819–1831. https://doi.org/10.1016/j.jacc.2019.10.066

Shaw, I., & Gregory, K. (2022). Acid–base balance: a review of normal physiology. BJA Education, 22(10), 396–401. https://doi.org/10.1016/j.bjae.2022.06.003

Sitepu, R. (2024). PENINGKATAN KESADARAN DAN PENANGANAN DINI STROKE HEMORAGIK : EDUKASI DAN PELATIHAN BAGI TENAGA KESEHATAN DI UNIT GAWAT DARURAT DI RUMAH SAKIT Improving Awareness And Early Management Of Hemorrhagic Stroke : Education And Training For Healthcare Personnel . 4(1), 170–173.

Siti Hanifah, Z., Siti Ulfah Rifa’atul Fitri, & Urip Rahayu. (2024). Penerapan Latihan Rom Pasif Terhadap Tingkat Kekuatan Otot Ekstremitas pada Pasien Stroke Hemoragik : Studi Kasus. Jurnal Medika Nusantara, 2(3), 77–90. https://doi.org/10.59680/medika.v2i3.1224

Szerlip, H. M., & Carolina, S. (2023). Acute Kidney Injury Acid-Base Disorders in the Critically Ill Patient. Clinical Journal of the American Society of Nephrology, 18(2), 102–112.

Windiyanto, R., I B Gd, S., IGL, S., & I N, B. H. (2016). Mortalitas Asidosis Metabolik Laktat dan Non-laktat di Unit Perawatan Intensif Pediatrik RSUP Sanglah. Sari Pediatri, 13(5), 351. https://doi.org/10.14238/sp13.5.2012.351-6