Retrospective Evaluation of Patients Diagnosed with Brain Death in the Intensive Care Unit: A 10-year Single Center Analysis

Abstract

Aim: This study aimed to investigate the demographic characteristics, clinical features, timing of the diagnosis of brain death, and factors associated with organ donation in patients diagnosed as brain dead in the intensive care unit in the last decade. Method: Between 01.01.2015-01.06.2024, the age, gender, intensive care unit hospitalization diagnoses, the day of intensive care unit hospitalization, blood groups, the number of patients diagnosed with brain death by years, the number of patients diagnosed with brain death, the number of patients who became donors, laboratory values on the day of intensive care unit hospitalization and the day of brain death diagnosis, the reasons why families did not accept organ donation were recorded from the patients' files and hospital information system. Results: A total of 59 patients were included in the study. Of the patients, 32 (54.24%) were female and 27 (45.76%) were male. The age distribution of the patients was seven (11.86%) aged 0-17 years, 29 (49.15%) aged 18-64 years, and 23 (38.98%) aged 65 years and older. The most common intensive care unit hospitalization diagnoses were intracerebral hemorrhage (35.59%), subarachnoid hemorrhage (16.95%), and CVA (13.56%). Although brain death was diagnosed in 83.05% of the patients in the first seven days, it was diagnosed in an average of 4.81 days in all patients. When the laboratory values between the day of admission to the intensive care unit and the day of brain death were diagnosed, a statistically significant difference was found in Na+, Cl-, K+, AST, BUN, and creatinine values (p<0.05). There was no significant difference in ALT and INR values (p>0.05). Among the reasons for not accepting organ donation, familial reasons were the highest, with 79.66%. Conclusion: In order to increase the number of organ donations, it is important to raise public awareness and increase the level of knowledge of families about organ donation. Patients with poor neurological prognosis with hospitalization diagnoses such as intracranial hemorrhage, CVA, and Post CPR should be closely monitored for brain death and potential donors.

Keywords

• Brain death
• Intensive care unit
• Organ donation
• Diagnosis
• Rejection

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