Hubungan Antara Skor Intracerebral Hemorragahe (ICH) dengan Mortalitas Pasien Perdarahan Intracerebral di RSU Royal Prima Medan
Keywords:
Intracerebral Hemorrhage, ICH Score, Glasgow Coma Scale, Mortality
Abstract
Intracerebral hemorrhage (ICH) is a form of hemorrhagic stroke with a high mortality rate. Assessment of severity using the ICH score is crucial for predicting prognosis and determining patient treatment priorities in hospitals. This study aims to determine the distribution of ICH patients based on the Glasgow Coma Scale (GCS) score, ICH volume, the presence of intraventricular hemorrhage (IVH), age, and location of the hemorrhage, and to analyze the relationship between ICH scores and patient mortality at Royal Prima Medan Hospital. This study used an observational-analytical design with a cross-sectional approach. The study population was all patients diagnosed with ICH during the study period, while a sample of 96 patients was obtained using the Lameshow formula. Data were collected through medical records and analyzed univariately and bivariately using the Chi-Square test. The results showed that most patients had a mild GCS score (53.1%), mild ICH volume (33.3%), and no intraventricular hemorrhage (52.1%). The largest age group was >60 years (56.3%), with the most common bleeding location being the right parietal (13.5%). The mortality rate reached 50%. Statistical tests showed no significant association between ICH score and mortality (p = 0.101), although clinically there was a trend towards an increased risk of death as the ICH score increased. Most patients presented with mild clinical conditions, but mortality remained high in more severe ICH scores. This study recommends improved early detection, more comprehensive radiological recording, and routine application of the ICH score as a prognostic tool in the management of patients with intracerebral hemorrhage.
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References
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Novitasari, D. Fuadi, I. Saleh, S.C. 2017. Penanganan Anestesi pada Ventriculo Peritoneal Shunt Cito e.c Hidrocephalus dengan Perdarahan Intraventricular. Jurnal Neuroanestesi Indonesia. 2017;6 (3): 178–86.
Reubsaet P, Brouwer AJ, van Haastert IC, Brouwer MJ, Koopman C, Groenendaal F, de Vries LS. The impact of low-grade germinal matrix-intraventricular hemorrhage on neurodevelopmental outcome of very preterm infants. Neonatology. 2017;112(3):203-10.
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Samarasekera, N. Et Al. (2015) ‘Influence Of Intracerebral Hemorrhage Location On Incidence, Characteristics, And Outcome: Population-Based Study’, Stroke, 46(2), Pp. 361–368.
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Vamsidhar Reddy, P., & Ps, P. (2024). Abc/2 Formula Versus Computer-Assisted Analysis In Calculating Intra-Cranial Haemorrhage Volume On Computed Tomographic Imaging. Computer Methods In Biomechanics And Biomedical Engineering.
Woo, D. Et Al. (2022) ‘Risk Factors Associated With Mortality And Neurologic Disability After Intracerebral Hemorrhage In A Racially And Ethnically Diverse Cohort’, Jama Network Open, 5(3), Pp. E221103–E221103.
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Yuniati, D., Syifak, S., Surya, P. A., & Saffanah, V. S. P. (2023). Intracerebral hemorrhage score as a prognosis prediction of spontaneous intracerebral hemorrhage at RSI Surabaya Jemursari. Aksona, 3(2), 67-73.
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Al Fauzi, A. (2020). Pedoman Penanganan Stroke Perdarahan Intraserebral. Airlangga University Press.
Al-Khaled, M., Awwad, S. And Brüning, T. (2020) ‘Nontraumatic Spontaneous Intracerebral Hemorrhage: Baseline Characteristics And Early Outcomes’, Brain And Behavior, 10(1).
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Aulia, N. N., Syifak, S., Yuniati, D., Alam, I. P., & Surya, P. A. (2023). Intracerebral Hemorrhage-Grading Scale (ICH-GS) score as a prognosis prediction of spontaneous intracerebral hemorrhage at Rumah Sakit Islam Surabaya Jemursari. Internasional Islamic Medical Journal (IIMJ), 4(2), 1- 12.
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Elisabet, F. K. (2021). Management Of Intracranial High Pressure On Stroke: A Narrative Review. Management, 14(3).
Fakiri, M.O. Uyttenboogaart, M. Houben, R. 2020. Reliability of the intracerebral hemorrhage score for predicting outcome in patients with intracerebral hemorrhage using oral anticoagulants. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.
Fauzi, A. Al (2020) Pedoman Penanganan Stroke Perdarahan Intraserebral: Evidence Based Guidelines. Airlangga University Press
Feigin, V.L. Et Al. (2021) ‘Global, Regional, And National Burden Of Stroke And Its Risk Factors, 1990-2019: A Systematic Analysis For The Global Burden Of Disease Study 2019’, The Lancet Neurology, 20(10), Pp. 1–26.
Gandi, F.S. Apriliyani, I. Utami, T. 2024. Penatalaksanaan Fisioterapi Pada Pasien Stroke Hemoragik Di Roujin Home Jepang. Jurnal ILKES (Jurnal Ilmu Kesehatan). Vol. 15 No. 1 Juni 2024.
Graham, A., Setiorini, A., Septiani, L., & Perdani, R. R. W. (2024). Glasgow Coma Scale: Tinjauan Terhadap Kegunaan, Keterbatasan, Dan Perkembangannya. Medula, 14(911), 2172.
Greenberg, M. S., & Arredondo, N. (2021). Handbook of neurosurgery. New York: Thieme.
Greenberg, M. S., & Arredondo, N. (2021). Handbook of neurosurgery. New York: Thieme.
Hemphill, J. C., Iii. (2024). Intracerebral Hemorrhage (Ich) Score: Estimates Mortality In Ich Based On Age And Ct Findings.
Hendrix, M., & Anderson, B. (2022). "Tumor-related Intraserebral Hemorrhage: Pathophysiology and Clinical Impact." Journal of Neurology, 39(5), 578584.
Hillal, A., Ullberg, T., Ramgren, B., & Wassélius, J. (2022). Computed tomography in acute intracerebral hemorrhage: neuroimaging predictors of hematoma expansion and outcome. Insights into imaging, 13(1), 180.
Hillal, A., Ullberg, T., Ramgren, B., & Wassélius, J. (2022). Computed tomography in acute intracerebral hemorrhage: neuroimaging predictors of hematoma expansion and outcome. Insights into imaging, 13(1), 180.
Ibrahim, R., Lalenoh, D.Ch. And Laihad, M.L. (2021) ‘Penanganan Pasien Perdarahan Intraserebral Di Ruang Rawat Intensif’, E-Clinic, 9(1). Jain, S. And Iverson, L.M. (2021) ‘Glasgow Coma Scale’, (5), Pp. 1–5. Jäkel, L. Et Al. (2022) ‘Prevalence Of Cerebral Amyloid Angiopathy: A Systematic Review And Meta-Analysis’, Alzheimer’s And Dementia, 18(1).
Kurniawan, M., Lestari, D. A., Harris, S., Rasyid, A., Mesiano, T., & Hidayat, R. (2023). Recurrent Intracerebral Hemorrhage as a Result of Cerebral Amyloid Angiopathy. Acta Neurologica Indonesia, 1(01).
Lioutas, V.A. Et Al. (2020) ‘Assessment Of Incidence And Risk Factors Of Intracerebral Hemorrhage Among Participants In The Framingham Heart
Study Between 1948 And 2016’, Jama Neurology, 77(10), Pp. 1252–1260. Ll M. Explaining Stroke, National Stroke Association. Published Online 2013.
Marini Awanis, Kenanga Marwan Sikumbang, Asnawati Asnawati. Korelasi antara Skor Intracerebral Hemorrhage (ICH) dengan Mortalitas Pasien Perdarahan Intraserebral di RSUD Ulin Banjarmasin. Jurnal Kesehatan Andalas. 2018;7.
Masturi, H., Hasanawi, A., & Hasanawi, A. (2021). Jurnal Inovasi Penelitian. Jurnal Inovasi Penelitian, 1(10), 1–208.
Mawuntu, A. H. P. (2019). Revisiting the Glasgow Coma Scale: Is it still relevant? Neurona, 36(3), 123-130.
Morotti, A. And Goldstein, J.N. (2016) ‘Diagnosis And Management Of Acute Intracerebral Hemorrhage’, Emergency Medicine Clinics Of North America, 34(4), Pp. 883–899.
Muhammad, B. Nabila, J. 2023. Perdarahan Intraserebal. Jurnal Ilmu Kesehatan dan Gizi (JIG) Vol.1, No.4 Oktober 2023 e-ISSN : :2964-7819; p-ISSN : :7962-0325, Hal 10-15.
Notoatmodjo, S. 2018. Metodologi Penelitian Kesehatan. Cetakan Ketiga. Jakarta: Pt Rineka Cipta.
Novitasari, D. Fuadi, I. Saleh, S.C. 2017. Penanganan Anestesi pada Ventriculo Peritoneal Shunt Cito e.c Hidrocephalus dengan Perdarahan Intraventricular. Jurnal Neuroanestesi Indonesia. 2017;6 (3): 178–86.
Reubsaet P, Brouwer AJ, van Haastert IC, Brouwer MJ, Koopman C, Groenendaal F, de Vries LS. The impact of low-grade germinal matrix-intraventricular hemorrhage on neurodevelopmental outcome of very preterm infants. Neonatology. 2017;112(3):203-10.
Sadewo, W. Amelia, L/ Tobing, H.G. 2017. Intraventricular Hemorrhage Outcome Operated On Neurosurgery Department Of Cipto Mangunkusumo Hospital. Neurona Vol. 35 No. 1 Desember 2017
Samarasekera, N. Et Al. (2015) ‘Influence Of Intracerebral Hemorrhage Location On Incidence, Characteristics, And Outcome: Population-Based Study’, Stroke, 46(2), Pp. 361–368.
Samino, S., & Bustami, M. (2017) Skor Ich-Gs Untuk Prediksi Prognosis Pasien Stroke Perdarahan Intraserebral Di Rumah Sakit Islam Jakarta Pondok Kopi. Cermin Dunia Kedokteran, 44(12), 398886.
Schrag, M., & Kirshner, H. (2020). Management of intracerebral hemorrhage: JACC focus seminar. Journal of the American College of Cardiology, 75(15), 1819-1831.
Schrag, M., & Kirshner, H. (2020). Management of intracerebral hemorrhage: JACC focus seminar. Journal of the American College of Cardiology, 75(15), 1819-1831.
Seiffge, D. J., & Anderson, C. S. (2024). Treatment for intracerebral hemorrhage: dawn of a new era. International Journal of Stroke, 19(5), 482-489.
Seiffge, D. J., & Anderson, C. S. (2024). Treatment for intracerebral hemorrhage: dawn of a new era. International Journal of Stroke, 19(5), 482-489.
Sitohang, S. (2021). The Relationship of ICH Score and 30-Day Mortality Rate in Hemorrhagic Stroke Patient: Systematic Review and Meta-Analysis. Sumatera Medical Journal, 4(2).
Sitohang, S. A. P. (2021). Hubungan Ich Score Terhadap 30-Day Mortality Rate Pada Pasien Stroke Hemoragik: Telaah Sistematis Dan Meta Analisis (Doctoral Dissertation, Universitas Sumatera Utara).
Sugiyono, M. (2024). Metode Penelitian Kuantitatif, Kualitatif, dan R&D. Bandung: Alfabeta.
Sugiyono. (2018). Metode penelitian kuantitatif. Bandung: Alfabeta.
Sugiyono. (2022). Metode Penelitian Kuantitatif, Kualitatif, Dan R&D. Bandung: Alfabeta.
Supriadhiana, I.G. Et Al. (2020) ‘Curiga Ruptur Arteriovenousmalformation Pada Kehamilan Preterm’, Callosum Neurology, 3(2).
Susanti, R. (2019). Sampling Dalam Penelitian Pendidikan. Jurnal Teknodik, 16, 187–208.
Suyanto. (2018). Metodologi Dan Aplikasi Penelitian Keperawatan (12th Ed.). Nufa Medika.
Vamsidhar Reddy, P., & Ps, P. (2024). Abc/2 Formula Versus Computer-Assisted Analysis In Calculating Intra-Cranial Haemorrhage Volume On Computed Tomographic Imaging. Computer Methods In Biomechanics And Biomedical Engineering.
Woo, D. Et Al. (2022) ‘Risk Factors Associated With Mortality And Neurologic Disability After Intracerebral Hemorrhage In A Racially And Ethnically Diverse Cohort’, Jama Network Open, 5(3), Pp. E221103–E221103.
World Health Organization (WHO). (2021). "Global Status Report on Noncommunicable Diseases 2020." Geneva: World Health Organization.
World Health Organization (WHO). (2022). Global Health Estimates: Stroke Mortality Statistics 2022. Geneva: WHO Press.
Xhaferri, A., Ramacciati, N., & Giusti, G. D. (2024). Beyond the GCS: An integrative review of new tools for neurological assessment in the intensive care unit for adult patients. Emergency Care Journal, 20, 12121.
Yuniati, D., Syifak, S., Surya, P. A., & Saffanah, V. S. P. (2023). Intracerebral hemorrhage score as a prognosis prediction of spontaneous intracerebral hemorrhage at RSI Surabaya Jemursari. Aksona, 3(2), 67-73.
Zeeva, E.J. Budiarti, R. Komang, N.S.D.U. 2023. Hubungan Antara Volume Perdarahan Dan Jumlah Leukosit Dengan Functional Outcome Pasien Perdarahan Intraserebral (Pis) Di Rspal Dr. Ramelan Surabaya. Surabaya Biomedical Journal.
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2025-11-30
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