Skip to main content Skip to main navigation menu Skip to site footer

The relationship of serum sodium and albumin levels on the severity of intracerebral hemorrhage

  • Louis Max Alfer Mailuhu ,
  • Muhammad Akbar ,
  • Andi Kurnia Bintang ,
  • Firdaus Hamid ,
  • Abdul Muis ,
  • Mimi Lotisna ,


Background: Hyponatremia causes complications and increases the severity of Intracerebral Hemorrhage (ICH) patients. Plasma albumin can be a neuroprotector against ICH by reducing brain volume and edema, increasing blood flow to the brain experiencing a perfusion crisis, and increasing microvascular perfusion. ICH patients with hypoalbuminemia have a 2-fold increased risk of worse outcomes and in-hospital death. This research was conducted to see the relationship between sodium and serum albumin levels on the severity of ICH patients.

Methods: This research is a cross sectional study where the number of research subjects was 69 people who met the inclusion criteria. Low serum sodium levels had a significant relationship with the severity of ICH patients as assessed by the NIHSS. Data were analyzed using SPSS version 27.0 for Windows.

Results: Admissions showed severe severity in 44 subjects (91.7%) with a value of 0.000 (<0.05). Low serum albumin levels have a significant relationship with the severity of ICH patients, showing severe severity in 50 subjects (96.2%) with a p-value of 0.000 (<0.05). Low serum sodium and albumin levels had the highest proportion of 97.6% with a severe severity level, while normal sodium and albumin levels were only 18.2% with a severe severity level. From the statistical test results, it was obtained that the p-value (0.000) < 0.05.

Conclusion: There is a relationship between the combination of serum sodium-albumin levels and the severity of ICH.



  1. Choy KW, Tsai APY, Lin PBC, Wu MY, Lee C, Alias A, et al. The role of urocortins in intracerebral hemorrhage. Biomolecules. 2020;10(1):96.
  2. Saha U, Hassan A, Zaman CF, Afroz S, Faruq R. The Striking Manifestation of Hyponatremia Due to Ischemic Stroke-Induced Cerebral Salt Wasting Syndrome (CSWS). NCBI. 2022;14(9): e29677.
  3. Golden N, Mardhika PE, Niryana W, Sukarya IM, Prabawa IPY. Risk factors and novel prognostic score for predicting the 14-day mortality of severe traumatic brain injury patients. Intisari Sains Medis. 2020;11(3):1020-1028.
  4. Domingues R, Rossi C, Cordonnier C. Classification of Intracerebral Haemorrhages. Eur Neurol Rev. 2014;9(1):129-135.
  5. Fisher SK, Heacock AM, Keep RF, Foster DJ. Receptor regulation of osmolyte homeostasis in neural cells. J. Physiol. 2010;18(1):3355–3364.
  6. Di Napoli M, Behrouz R, Topel CH, Misra V, Pomero F, Giraudo A, et al. Hypoalbuminemia, systemic inflammatory response syndrome, and functional outcome in intracerebral hemorrhage. Journal of critical care. 2017;41(1):247-253.
  7. Soeters BP, Wolfe RR, Shenkin A. Hypoalbuminemia: Pathogenesis and Clinical Significance. Journal of Parenteral and Enteral Nutrition Volume. 2019;43(2):181–193.
  8. Panda M, Sahu KP, Mandal KM, Mohapatra KA, Dany SS. Status elektrolit serum yang berubah pada pasien stroke akut di Western Odisha, prediktor Syndrome of Inappropriate ADH (SIADH) atau Cerebral Salt Washing Syndrome (CSWS). Jurnal Penelitian Klinis dan Diagnostik. 2019;13(1): 10-13.
  9. Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJB, Culebras A, et al. An updated definition of stroke for the 21st Century. Stroke. 2013;44(7):2064–2089.
  10. Alishlash MISA, Al-Shammari SHM. Electrolytes Status, Blood Urea, And Serum Creatinine as a Prognostic of Functional Outcomes in Acute Stroke. Volume 44, Issue 06. University of Mosul, Mosul, Iraq. 2021;44(06):2737-2747.
  11. Sasmita PK, Setyopranoto I, Wibowo S, Sadewa AH. Correlation between serum S100β protein level with neurological deficit in patients with acute intracerebral hemorrhage. Bali Medical Journal. 2018;8(1):63–68.
  12. Moiz E, Mawa M, Kuldeep R, Tooba H, Kavita FNU, Besham K. Clinical Spectrum of Hyponatremia in Patients with Stroke. Cureus. 2019;11(8):1-11.
  13. Tisdall M, Crocker M, Watkiss J, Smith M. Disturbances of sodium in critically ill adult neurologic patients: a clinical review. Journal of neurosurgical anesthesiology. 2006;18(1):57.
  14. Rizal A, Faisal A, Dwidanarti SR. Correlation of Volume and Intracerebral Site with Hemorrhagic Stroke Mortality Based on CTScan. Department of Radiology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta. 2018;1(1):20.
  15. Verbalis JG, Goldsmith SR, Greenberg A, Korzelius C, Schrier RW, Sterns RH, et al. Diagnosis, evaluation, and treatment of hyponatremia: Expert panel recommendations. Am. J. Med. 2013;126(10):S1-S42.
  16. Shaikh F, Shaikh FH, Chandio SA. Frequency of Hypoalbuminemia and In-Hospital Mortality in Acute Ischemic Stroke Patients Presenting at a Tertiary Care Hospital, Hyderabad. Cureus. 2021;13(4):e14256.
  17. Bawazir LAA. Limitations of serum albumin level as a marker of nutritional status in hemodialysis patients. Bali Medical Journal. 2020;9(1):149–154.
  18. Branko FHR, Lesmana T. C-Reactive Protein (CRP)/Albumin Ratio (CAR) pre-treatment as a predictive factor of radiological response after neoadjuvant chemotherapy in Locally Advanced Rectal Cancer (LARC) patients at Dr. Soetomo General Hospital, Surabaya, Indonesia. Bali Medical Journal. 2022;11(1):50–55.

How to Cite

Mailuhu, L. M. A., Akbar, M., Bintang, A. K. ., Hamid, F., Muis, A., & Lotisna, M. (2024). The relationship of serum sodium and albumin levels on the severity of intracerebral hemorrhage. Indonesia Journal of Biomedical Science, 18(1), 83–86.




Search Panel