Effects of IKAP Health Education and Exercise Therapy on Clinical Outcomes in Hypertensive Intracerebral Hemorrhage

Summary

Information-Knowledge-Attitude-Practice-based health education, combined with exercise nursing, improves electrolyte homeostasis and hepatorenal function in hypertensive patients with intracerebral hemorrhage. The multiple organ dysfunction syndrome risk model built with CRP, K+, Scr, UA, and GGT has high sensitivity and specificity.

Abstract

The study aims to investigate the effects of the Information-Knowledge-Attitude-Practice (IKAP) health education combined with exercise therapy model on electrolyte homeostasis, liver function, and kidney function in patients with hypertensive intracerebral hemorrhage (HICH), and to construct a multidimensional biomarker-based multiple organ dysfunction syndrome (MODS) risk prediction model to provide new strategies for organ function support therapy in critically ill patients. A total of 102 HICH patients admitted between October 2023 and June 2025 (inclusive) were enrolled and underwent IKAP health education and staged exercise rehabilitation training. Blood tests (WBC, RBC, HGB, CRP), electrolyte levels (Na⁺, K⁺, Cl-, Ca2⁺), liver function (ALB, ALT, AST, ALP, TBIL, GGT), and kidney function (BUN, Scr, UA) were measured before and after care, and the incidence of MODS was calculated. Logistic regression analysis was used to identify independent risk factors for MODS, establish a risk prediction model, and validate its efficacy. The post-care levels of WBC, CRP, Na⁺, K⁺, BUN, Scr, UA, ALT, AST, and GGT were significantly lower than pre-care levels (p<0.05). Multivariate logistic regression analysis identified CRP, K⁺, Scr, UA, and GGT as independent risk factors for MODS. The ROC curve AUC for predicting MODS was 0.9195, with a sensitivity of 74.07% and specificity of 94.67%. Conclusively, IKAP health education combined with exercise therapy improves electrolyte homeostasis and liver function and kidney function in HICH patients. The MODS risk prediction model based on CRP, K⁺, Scr, UA, and GGT demonstrates high sensitivity and specificity.

Introduction

Hypertensive intracerebral hemorrhage (HICH) is a common and critical neurological emergency, accounting for approximately 10%-15% of all stroke cases. Although not the most frequent type of stroke, it is characterized by high incidence, substantial disability, and considerable mortality due to acute complications¹. Epidemiological data from China indicate approximately 1.6 million new HICH cases annually, with 30% experiencing deteriorating conditions or death due to complications such as acute-phase electrolyte imbalances and hepatic-renal dysfunction^2,3. Post-HICH, stress-induced pat....

Protocol

This study involving human subjects was conducted in compliance with the Declaration of Helsinki and approved by the Ethical Committee of The People's Hospital of Yingshang (Approval No. 2025-18). Written informed consent was obtained from all participants prior to their enrollment in the study, with detailed explanations provided regarding the study's objectives, procedures, potential risks, and benefits.

Study design

This was a prospective non-randomized single-center study. The study population consisted of 102 patients diagnosed with HICH according to the HICH diagnostic criteria⁸

Results

Comparison of clinical baseline data

There was no statistically significant difference in age, gender, and APACHE II scores between the observation and the control groups (P>0.05), indicating comparability (Table 1).

Changes in blood count

First, the blood count results before and after nursing care were compared. It can be seen that there was no significant change in RBC and HGB in bo.......

Discussion

HICH patients often develop MODS due to electrolyte disturbances, hepatorenal function injury, and coagulation abnormalities, leading to adverse prognoses¹³. This study, as far as we are aware, is the first to apply IKAP-based health education plus exercise nursing to HICH patients. Through multi-dimensional biomarker monitoring, it was found that the patients' electrolyte, liver, and kidney functions were effectively improved. This demonstrates that our proposed framework improves organ prote.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Blood cell analyzer	Sysmex	XN-1000‌	Eighty samples were tested per hour, and the impedance method + flow cytometry + fluorescence staining technology was integrated to support 26 parameters
Fully automated biochemical analyzer	Roche Cobas	8000	The automatic biochemical immunoassay system produced by Roche Diagnostics Co., LTD., with efficient and accurate detection ability, is mainly used for the detection of biochemical, immune and electrolyte items in clinical laboratories.
Fully automated biochemical analyzer	AU5800	Beckman Coulter	Beckman Coulter's fully automated biochemistry analyzers are designed for use in large or very large clinical laboratories and support high efficiency, modular configuration, and intelligent operation.
Lyphochek	Bio-Rad Laboratories	http://www.swablab.com/archives/60787.html	A series of in vitro diagnostic quality control products produced by Bio-Rad Laboratories are mainly used to monitor the precision of laboratory testing processes, covering a variety of clinical testing fields.
SPSS	IMB	24	A statistical analysis software for data processing, data analysis and data visualization.