Garuda - Garba Rujukan Digital

Article Per Year (5 Year)

All

The International Journal of Medical Science and Health Research

ijmhsr
Website

Published by International Medical Journal Corp. Ltd.

ISSN : 30481376 EISSN : 30481368 DOI : -

Core Subject : Health,

Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

The International Journal of Medical Science and Health Research, published by International Medical Journal Corp. Ltd. is dedicated to providing physicians with the best research and important information in the world of medical research and science and to present the information in a format that is understandable and clinically useful. Committed to publishing multidisciplinary research that spans the entire spectrum of healthcare and medicine access, The American Journal of Medical Science and Health Research aims at an international audience of pharmacists, clinicians, medical ethicists, regulators, and researchers, providing an online forum for the rapid dissemination of recent research and perspectives in this area.

Arjuna Subject : Kedokteran - Review dan Referensi, Kedokteran

Articles 608 Documents

57 58 59 60 61

The Role of Primary Health Care in Early Detection of Preeclampsia: A Case Series from a Community Health Center Puri Kahitna Sudibyo
The International Journal of Medical Science and Health Research Vol. 48 No. 2 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/zwndek26

Introduction: Preeclampsia remains a leading cause of maternal and perinatal morbidity and mortality in Indonesia. Early detection at the primary health care (PHC) level is critical yet often hampered by incomplete risk assessment. This study evaluates the clinical application of the Maternal and Child Health Book (Buku KIA), Poedji Rochjati Score Card (KSPR), Mean Arterial Pressure (MAP), and Roll-Over Test (ROT) for early preeclampsia screening at a community health center. Case Illustration: Three pregnant women at Puskesmas Tambakrejo, Surabaya, are described. Case 1 (38 years, G3P2A0, 20 weeks) had gestational hypertension with a KSPR score of 6 (high-risk), prompting Methyldopa and calcium prophylaxis followed by planned referral. Case 2 (22 years, G1P0A0, 29 weeks) presented with asymptomatic severe preeclampsia (BP 173/121 mmHg, proteinuria 1+, KSPR 12), requiring immediate emergency transfer. Case 3 (28 years, G3P1A1, 4-5 weeks) had chronic hypertension, prior preterm preeclampsia, positive MAP/ROT, and KSPR 12, leading to immediate Amlodipine and tertiary referral. Discussion: Standardized KSPR scoring successfully stratified patients into clear risk categories. MAP and ROT detected subclinical vascular dysfunction, particularly in early gestation. While management aligned with national (POGI) and international (ACOG/WHO) guidelines, gaps persisted in dipstick-only proteinuria assessment, incomplete documentation, and inconsistent prophylactic agent availability. Conclusion: Integrated Maternal and Child Health Book, KSPR, MAP, and ROT screening at the PHC level enables early preeclampsia detection, timely stabilization, and structured referrals. Digitalization, supply chain strengthening, and provider training are recommended to reduce maternal mortality.

Dextrocardia with Situs Inversus Totalis and Subaortic-Type Double Outlet Right Ventricle in an Adult: A Case Report Dian Komala Dewi; Zakir Fendy Abdul Razak
The International Journal of Medical Science and Health Research Vol. 48 No. 2 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/v05y3b05

Background: Dextrocardia with situs inversus totalis (SIT) is a rare congenital condition, and significant congenital heart disease (CHD) complicates only approximately 0% to 10% of affected individuals. The coexistence of subaortic-type double outlet right ventricle (DORV) in adults is exceptionally uncommon. Mirror-image anatomy further complicates cardiovascular assessment and may lead to diagnostic misinterpretation without systematic segmental analysis and multimodal imaging. Case Presentation: A 29-year-old man presented with chronic cyanosis, exertional dyspnea, and a three-month history of worsening symptoms accompanied by 5 kg of unintentional weight loss. Chest radiography demonstrated a right-sided gastric bubble. Transthoracic echocardiography identified a large subaortic ventricular septal defect (VSD) measuring 27.3 mm and a left ventricular ejection fraction of 51%. Contrast-enhanced cardiac computed tomography (CT) with three-dimensional reconstruction confirmed dextrocardia, SIT, atrial situs inversus, a right aortic arch, subaortic-type DORV with aortic override, and imaging features suggestive of pulmonary hypertension. Conclusion: This case underscores the diagnostic value of cardiac CT in definitively classifying complex conotruncal anatomy in the setting of mirror-image laterality. Early referral to an adult congenital heart disease center and formal pulmonary vascular assessment are essential when corrective intervention remains under consideration. Radiologists should maintain high suspicion for visceral situs inversus when a right-sided gastric bubble is identified on chest radiography.

Relationship between Bacterial Vaginosis Infection and the Risk of Premature Rupture of Membranes: A Systematic Review of Randomized Controlled Trial and Primary Studies Venasari
The International Journal of Medical Science and Health Research Vol. 48 No. 2 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/21k53j63

Introduction: Bacterial vaginosis (BV) represents the most prevalent vaginal dysbiosis among reproductive-age women, characterized by depletion of hydrogen peroxide-producing Lactobacillus species and overgrowth of anaerobes including Gardnerella vaginalis and Atopobium vaginae. During gestation, BV has been mechanistically linked to premature rupture of membranes (PROM) through enzymatic degradation of chorioamniotic membranes, upregulation of matrix metalloproteinases (MMPs), and pro-inflammatory cytokine cascade activation. This systematic review aimed to synthesize evidence from randomized controlled trials (RCTs) and primary studies examining the association between BV infection and PROM risk. Methods: A comprehensive systematic review was conducted following PRISMA 2020 guidelines. Included studies comprised pregnant women with confirmed BV diagnosis (Nugent score ≥7, Amsel criteria, or molecular methods) reporting PROM as an outcome. Risk of bias was assessed using Cochrane RoB 2 for RCTs and Newcastle-Ottawa Scale for observational studies. Fifteen primary studies encompassing 42,318 pregnant women met full inclusion criteria. Results: BV-positive pregnant women demonstrated significantly elevated PROM risk compared to BV-negative controls (pooled OR 2.19, 95% CI 1.54–3.12). Preterm PROM (PPROM) risk was more pronounced (OR 2.73, 95% CI 1.84–4.05). The PREMEVA trial (n=3,344) showed no significant PROM reduction with early clindamycin in low-risk populations, whereas high-risk subgroups demonstrated benefit (OR 0.14–0.56). BV-associated organisms produce phospholipase A2, sialidase, and collagenase, directly degrading fetal membrane integrity. Secondary outcomes included chorioamnionitis (OR ~3.0), neonatal sepsis (OR 1.60), and low birth weight (OR 1.73). Discussion: Consistent evidence supports a biologically plausible BV-PROM association through enzymatic and inflammatory pathways. Treatment trial heterogeneity arises from differences in diagnostic criteria, gestational age at intervention, population risk profiles, and antibiotic regimens. Microbiome-based community state type IV (high diversity, Lactobacillus-depleted) confers highest PPROM risk. Conclusion: Bacterial vaginosis constitutes a significant, modifiable risk factor for PROM/PPROM. Universal early-pregnancy BV screening with targeted antibiotic treatment for high-risk populations is warranted. Microbiome-guided therapeutic strategies require further RCT investigation.

Effectiveness of Zinc Supplementation in Nutritional Catch-Up Growth Management for Stunted Toddlers: A Systematic Review of Randomized Controlled Trials and Primary Studies Kartika Dewi
The International Journal of Medical Science and Health Research Vol. 48 No. 2 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/t4ec9f25

Introduction: Stunting affects 148.1 million children under five globally, with zinc deficiency mechanistically implicated through impaired IGF-1 signaling and cellular proliferation. This systematic review evaluates the effectiveness of zinc supplementation on linear growth, ponderal growth, biomarkers, and morbidity outcomes in stunted toddlers. Methods: The study strictly adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines from inception to June 2025. Included studies comprised RCTs, cluster-RCTs, or primary studies enrolling children aged 0–72 months receiving oral zinc supplementation with at least one anthropometric or morbidity outcome. Risk of bias was assessed using Cochrane RoB 2.0. Narrative synthesis was employed with pooled estimates derived from included meta-analyses. Results: Zinc supplementation significantly improved linear growth in stunted children (effect size 0.13–0.50 SD), with the most pronounced effect in Ethiopian infants (7.0 cm vs 2.8 cm placebo, p<0.001). Weight gain showed consistent positive effects (ES 0.309, 95% CI 0.178–0.439). Serum zinc responded robustly (ES 0.820). Zinc reduced diarrhea (OR 0.82, 95% CI 0.72–0.93) and pneumonia (OR 0.59, 0.41–0.83). All-cause mortality was reduced by 16% (SRR 0.84). However, stunting prevalence was not consistently reduced, with attenuation observed in settings with high environmental enteric dysfunction or iron co-supplementation. Discussion: Zinc demonstrates significant benefit for linear growth velocity in zinc-deficient stunted toddlers, mediated through IGF-1 upregulation, improved appetite, and reduced infectious morbidity. Contextual heterogeneity is driven by baseline zinc status, co-existing deficiencies, EED burden, and iron co-supplementation. Conclusion: Zinc supplementation at 10 mg/day for ≥24 weeks is effective for improving linear growth velocity and reducing morbidity in stunted toddlers with zinc deficiency, though insufficient as monotherapy for reversing stunting prevalence. Integrated approaches addressing multifactorial etiology are recommended.

Pulmonary Rehabilitation for Interstitial Lung Disease Associated with Connective Tissue Disease: A Systematic Review of Randomized Controlled Trials and Primary Studies Yessica Fianita; Yeni Oktasari
The International Journal of Medical Science and Health Research Vol. 48 No. 3 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/g1s3gd47

Introduction: Connective tissue disease-associated interstitial lung disease (CTD-ILD) is a progressive, disabling condition with high morbidity and mortality. Pulmonary rehabilitation (PR) has emerged as an evidence-based non-pharmacological intervention; however, a comprehensive synthesis specifically addressing CTD-ILD populations across multiple clinically relevant outcome domains remains absent. This systematic review evaluates the efficacy and safety of PR in CTD-ILD across ten outcome domains. Methods: This systematic review was conducted in accordance with PRISMA 2020 guidelines. RCTs and prospective primary studies involving adults with ILD or CTD-ILD receiving structured PR were eligible. Two independent reviewers screened titles/abstracts and full texts. Risk of bias was assessed using Cochrane RoB 2.0 for RCTs and ROBINS-I for non-randomized studies. Narrative synthesis was employed due to heterogeneity in PR programs, ILD subtypes, and outcome instruments. Results: Fifteen studies (13 RCTs, 2 prospective cohorts; n=1,002) published between 2008–2023 met inclusion criteria. PR significantly improved 6-minute walk distance (pooled +40 m, 95% CI 32–47 m; p<0.001), with CTD-ILD subgroups showing +42 m (95% CI 25–60 m) and sustained improvements at 6 months. Health-related quality of life (SGRQ –8 to –12 points), dyspnea, peripheral muscle strength, and fatigue all improved significantly. Pulmonary function (FVC, DLCO) was unchanged. No serious adverse events attributable to PR were recorded. Telerehabilitation and high-intensity interval training demonstrated comparable efficacy to conventional programs. Discussion: PR is safe and effective in CTD-ILD, with improvements in exercise capacity, quality of life, dyspnea, and fatigue. CTD-ILD patients sustain PR benefits longer than IPF patients, reflecting a more variable disease trajectory. Both HIIT and MICT yield comparable outcomes. Evidence is limited by heterogeneous CTD-ILD subgroup representation, small sample sizes, and short follow-up durations. The exercise capacity–physical activity translational gap requires targeted behavioral interventions. Conclusions: PR significantly improves exercise capacity, quality of life, dyspnea, and fatigue in CTD-ILD and is safe when appropriately supervised. Dedicated RCTs specifically designed for CTD-ILD subgroups are urgently needed to establish disease-specific PR protocols and long-term maintenance strategies.

Thyroid Autoimmunity in Children with Type 1 DM : A Comprehensive Systematic Review Arya Adi Bramasta; Ivan Veriswan; Joko Utoro; Ernawati
The International Journal of Medical Science and Health Research Vol. 48 No. 3 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/gse06b85

Background: Type 1 diabetes mellitus (T1DM) in children is frequently complicated by autoimmune thyroid disease (AITD), yet substantial heterogeneity exists in reported prevalence, risk factors, and optimal screening protocols. Methods: This systematic review synthesized 80 sources including primary observational studies, meta-analyses, and clinical guidelines from Europe, Asia, Africa, the Middle East, and North America. Data extraction focused on thyroid autoantibody (TPOAb, TgAb, TRAb) prevalence, clinical thyroid disease outcomes (hypothyroidism, hyperthyroidism), risk factors (sex, age, genetics, ethnicity), progression rates from antibody positivity to clinical disease, screening recommendations, and impact on diabetes management. Results: Thyroid autoantibody prevalence ranged from 6.7% to 44.8% across studies, with most reporting 15–30%. The pooled prevalence of hypothyroidism from meta-analysis was 9.8% (95% CI: 7.5–12.3), while hyperthyroidism occurred in only 1.3% (95% CI: 0.9–1.8). Female sex was the strongest demographic risk factor, with females 1.9 to 2.4 times more likely to have thyroid autoimmunity. Heritability of TPO antibodies was estimated at 69% (95% CI: 50–82%) in discordant twin pairs. Over 30-year follow-up, 84% of TPO-positive patients at T1DM diagnosis developed thyroid dysfunction, with a median time to dysfunction of 5 years (relative risk 8.1, 95% CI: 4.79–13.69). Annual conversion rates from euthyroid autoimmunity to hypothyroidism ranged from 3–18% per year. Levothyroxine in euthyroid antibody-positive patients reduced thyroid volume but did not prevent progression to hypothyroidism. Discussion: Female sex, older age, longer diabetes duration, and specific HLA haplotypes (DR3-DQ2, DR4-DQ8) consistently predicted thyroid autoimmunity. Ethnicity significantly influences prevalence, with lower rates in African American cohorts. TPO antibody positivity at T1DM diagnosis is a strong long-term predictor of clinical disease, but initially antibody-negative patients remain at risk and require continued periodic screening. Sick euthyroid syndrome at diagnosis frequently causes transient thyroid function abnormalities, particularly during diabetic ketoacidosis, warranting cautious interpretation. Conclusion: Thyroid autoimmunity affects approximately 15–30% of children with T1DM, with female predominance and strong heritability. All children should undergo TPO antibody and TSH testing at T1DM diagnosis. Antibody-positive patients require annual TSH monitoring, while antibody-negative patients can be screened every 2 years from puberty through adulthood. Levothyroxine is not recommended for euthyroid antibody-positive patients.

EFFECTIVENESS OF INTRALESIONAL CORTICOSTEROID INJECTION FOR NODULOCYSTIC ACNE : A SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS AND PRIMARY STUDIES Rielyana Lumban Gaol
The International Journal of Medical Science and Health Research Vol. 48 No. 3 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/1w9bbs83

Introduction: Nodulocystic acne represents the most severe phenotype of acne vulgaris, associated with significant physical and psychosocial morbidity. Intralesional corticosteroid injection (ILC) has been used clinically for >60 years, yet systematic evidence synthesis remains limited. This review aims to evaluate the efficacy, safety, and optimal concentration of ILC for nodulocystic acne. Methods: Systematic review conducted according to PRISMA 2020 guidelines. Included studies comprised RCTs, quasi-RCTs, comparative cohort studies, pre-post studies, and case series (n≥5). Risk of bias was assessed using Cochrane RoB 2.0 and Newcastle-Ottawa Scale. Results: Fifteen studies comprising 1,247 subjects were included. Triamcinolone acetonide (TA) at concentrations of 0.63–5 mg/mL demonstrated consistent efficacy, with symptomatic improvement onset within 24–72 hours and median lesion resolution of 4.6–8.1 days depending on modality. Lesion diameter reduction reached 65–85% by Day 7. Mean VAS pain score reduction was 2.27 points (p<0.0001) with cryoanesthesia. TA-loaded detachable microneedle patch (DMN) technology demonstrated faster resolution (median 4.6 vs 8.1 days; p<0.05). Betamethasone phosphate showed no superiority over saline control (p=0.16). Incidence of cutaneous atrophy and hypopigmentation was <5% with appropriate injection technique. Discussion: TA at 0.63–2.5 mg/mL constitutes the most effective and safe ILC agent. Technical innovations (cryoanesthesia, DMN) significantly improve tolerability and accessibility. Major limitations include scarcity of high-quality RCTs, design heterogeneity, and absence of longitudinal data. Conclusion: Intralesional triamcinolone acetonide injection at 0.63–2.5 mg/mL represents an effective, safe, and rapidly responsive therapeutic modality for nodulocystic acne. Large-scale multicenter RCTs with ≥6 months follow-up are urgently required.

Use of Tenecteplase in Acute Ischemic Stroke : A Systematic Review of Randomized Controlled Trials and Primary Studies Bayu Aji Perdana; Mega Siti Fasicha
The International Journal of Medical Science and Health Research Vol. 48 No. 3 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/dkzaqp39

Background: Tenecteplase (TNK), a bioengineered variant of alteplase with superior fibrin specificity, prolonged plasma half-life, and single-bolus administration, has emerged as a promising alternative thrombolytic agent in acute ischemic stroke (AIS). The growing body of randomized controlled trial (RCT) evidence necessitates a comprehensive synthesis to guide clinical implementation. Objectives: To systematically evaluate the efficacy and safety of tenecteplase compared with alteplase or standard medical care in adult patients with AIS across multiple clinical scenarios, doses, and time windows, drawing upon all available high-quality RCT evidence. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. RCTs and primary studies comparing tenecteplase with alteplase or standard medical care in AIS were eligible. Two independent reviewers performed screening, data extraction, and risk of bias assessment using the Cochrane Risk of Bias 2.0 (RoB 2) tool. Primary outcomes included excellent functional outcome (modified Rankin Scale [mRS] 0–1 at 90 days), functional independence (mRS 0–2), symptomatic intracranial hemorrhage (sICH), and 90-day mortality. Results: Seventeen primary studies enrolling over 11,800 patients met inclusion criteria. Tenecteplase at 0.25 mg/kg was non-inferior or superior to alteplase (0.9 mg/kg) for excellent functional outcome at 90 days across multiple large-scale RCTs (AcT, TRACE-2, ORIGINAL, ATTEST-2, TASTE). Updated meta-analysis confirmed TNK superiority for mRS 0–1 at 3 months (RR 1.05; 95% CI 1.01–1.10). Symptomatic intracranial hemorrhage rates were comparable (RR 1.12; 95% CI 0.83–1.53). Intravenous TNK prior to endovascular thrombectomy (BRIDGE-TNK) achieved significantly higher functional independence (52.9% vs. 44.1%; RR 1.20; 95% CI 1.01–1.43). Extended-window TNK (TRACE-III, TIMELESS) demonstrated benefit in selected patients. The 0.4 mg/kg dose was associated with increased hemorrhagic risk. Conclusion: Tenecteplase 0.25 mg/kg is non-inferior—and in several outcomes superior—to alteplase for AIS thrombolysis within 4.5 hours, with comparable safety. Single-bolus administration confers operational advantages. Tenecteplase should be considered the preferred thrombolytic agent in current AIS management, particularly in settings with endovascular capability.

The Relationship between the Use of Artificial Intelligence and Waiting Time for Emergency Chest X-Ray Interpretation: A Systematic Review of Randomized Controlled Trials and Primary Studies Novita Lusiana
The International Journal of Medical Science and Health Research Vol. 48 No. 3 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/w2zaj884

Introduction: Delayed interpretation of emergency chest X-rays (CXRs) represents a critical bottleneck in emergency department (ED) workflow, potentially compromising outcomes in time-sensitive conditions. Artificial intelligence (AI) algorithms have demonstrated capacity for automated detection and prioritization of radiographic findings, offering a potential solution to interpretation delays. Methods: A systematic search adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines for studies evaluating AI-assisted CXR interpretation in emergency settings reporting time-related outcomes. Risk of bias was assessed using QUADAS-2 and RoB 2.0 tools. Seventeen primary studies encompassing 16 distinct AI algorithms and over 1.2 million CXR images were included. Results: AI implementation was consistently associated with significant reductions in mean report turnaround time (RTAT; range: 2.7–29.7 minutes reduction) and radiologist reading time (average reduction 13–27%). Active worklist prioritization reduced RTAT for critical findings from 80.1 to 35.6 minutes (p<0.0001) and reduced average reporting delay from 11.2 to 2.7 days. AI-assisted interpretation improved diagnostic sensitivity for pneumothorax (AUC 0.97), pleural effusion (AUC 0.94–0.97), and consolidation (AUC 0.83–0.88). Non-radiology emergency clinicians derived greatest benefit, with pneumothorax AUC improving from 0.846 to 0.974 with AI assistance. Generative AI models produced reports of equivalent clinical accuracy to radiologists while improving documentation efficiency by 15.5%. Discussion: AI integration significantly reduces RTAT and optimizes worklist prioritization, particularly for critical findings. Active worklist re-ordering algorithms produced greater RTAT reductions (43.7%) than passive notification systems (7.6%). Algorithmic bias against underserved populations and false-negative safety risks mandate mandatory equity auditing and time-cap mechanisms prior to clinical deployment. Conclusion: AI implementation for emergency CXR interpretation is clinically effective in reducing waiting time and RTAT, improving diagnostic sensitivity, and enhancing workflow efficiency. Active worklist prioritization systems yield greatest benefit. Future prospective multicenter randomized controlled trials are necessary to establish standardized implementation protocols and evaluate long-term clinical outcomes.

Relationship Between Intracerebral Hemorrhage Volume on CT Scan and Glasgow Coma Scale Score: A Systematic Review of Randomized Controlled Trials and Primary Studies Novita Lusiana
The International Journal of Medical Science and Health Research Vol. 48 No. 3 (2026): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/8f24qw51

Introduction Intracerebral hemorrhage (ICH) constitutes approximately 10–15% of all strokes globally and remains one of the most devastating forms of acute cerebrovascular disease, with 30-day mortality rates exceeding 40%. The Glasgow Coma Scale (GCS) and hematoma volume measured via non-contrast CT scan are two of the most widely studied clinical and radiological parameters in the acute prognostication of ICH. Despite robust individual evidence, comprehensive systematic synthesis examining the direct quantitative relationship between ICH volume on CT and GCS score is lacking. This systematic review aims to consolidate existing evidence on this critical association to inform clinical decision-making, risk stratification, and therapeutic planning. Methods A systematic literature search was conducted from inception through June 2025, in accordance with PRISMA 2020 guidelines. Studies were included if they reported quantitative data on both ICH volume (measured by CT-based ABC/2 or planimetric method) and GCS score in adult patients with spontaneous supratentorial or infratentorial ICH. Results A total of 18 eligible studies comprising 8,247 patients were included. ICH volume was consistently and inversely correlated with GCS score across all included studies (r = -0.58 to -0.82; all p < 0.001). Patients with GCS 3–8 (severe depression) demonstrated hematoma volumes significantly greater than those with GCS 9–12 (moderate) or GCS 13–15 (mild-to-normal): mean difference of 28.4 mL (95% CI: 22.1–34.7 mL; p < 0.001). An ICH volume threshold of ≥30 mL independently predicted GCS ≤ 8 (OR 4.21; 95% CI 3.15–5.63; p < 0.001). Intraventricular hemorrhage extension, deep ICH location, and hematoma expansion further amplified the GCS-volume relationship. The ICH Score (which integrates both GCS and volume) demonstrated superior prognostic accuracy (AUC 0.86–0.91) compared to either parameter alone. Discussion The strong inverse relationship between ICH volume and GCS score reflects the direct effect of hematoma mass on intracranial pressure and cortical/subcortical functional depression. Location-specific volume thresholds modulate this relationship: deep-seated hemorrhages (thalamic, basal ganglia) produce greater neurological depression at smaller volumes compared to lobar hemorrhages. Serial neurological assessment using GCS at 6 hours post-admission adds incremental prognostic value beyond baseline imaging. Clinicians must avoid prognostic nihilism, as aggressive neurocritical care may significantly attenuate predicted mortality. Conclusion ICH volume on CT scan is a robust, independent predictor of GCS score and neurological outcome. A cut-off volume of ≥30 mL represents a clinically meaningful threshold associated with severe consciousness depression (GCS ≤ 8) and adverse outcomes. Integration of both GCS and ICH volume into composite scoring (e.g., ICH Score, max-ICH Score) maximizes prognostic accuracy. Future prospective multicenter studies and well-powered RCTs are warranted to validate volume-specific GCS cut-points across diverse populations.

Page 60 of 61 | Total Record : 608

57 58 59 60 61

Filter by Year

2022 2026

Filter By Issues

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name
Indra Hadi

Contact Email
profesionaljournalmedicine@gmail.com

Phone
-

Journal Mail Official
pt.internationalmedicaljournal@gmail.com

Editorial Address
Equity Tower. 49th Floor. Sudirman Street. Special Region of Jakarta, Indonesia

Location
Kota adm. jakarta selatan,

Dki jakarta

INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Indra Hadi

Contact Email profesionaljournalmedicine@gmail.com

Phone -

Journal Mail Official pt.internationalmedicaljournal@gmail.com

Editorial Address Equity Tower. 49th Floor. Sudirman Street. Special Region of Jakarta, Indonesia

Location Kota adm. jakarta selatan, Dki jakarta INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Indra Hadi

Contact Email
profesionaljournalmedicine@gmail.com

Phone
-

Journal Mail Official
pt.internationalmedicaljournal@gmail.com

Editorial Address
Equity Tower. 49th Floor. Sudirman Street. Special Region of Jakarta, Indonesia

Location
Kota adm. jakarta selatan,

Dki jakarta

INDONESIA