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Neurocritical Patient Characteristics Related to Brain Death.

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The Glasgow 7 Program identified acute neurological patients likely to progress to brain death (BD). Female sex, penetrating head injury, subarachnoid hemorrhage, and spontaneous intracerebral hematoma were associated with higher BD likelihood.

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Area of Science:

  • Neurology
  • Transplantation Medicine
  • Public Health

Background:

  • Limited organ availability for transplantation necessitates innovative donor identification strategies.
  • The Glasgow 7 Program in Argentina identifies acute neurological patients with Glasgow scores ≤7 for potential organ donation.
  • This study evaluates factors influencing progression to brain death (BD) in these patients.

Purpose of the Study:

  • To determine the likelihood of hospitalized acute neurological patients progressing to brain death (BD).
  • To identify key demographic and diagnostic variables associated with BD progression.
  • To inform organ procurement strategies within the Glasgow 7 Program.

Main Methods:

  • Retrospective cohort analysis of the SINTRA database (2006-2015).
  • Inclusion of patients with Glasgow scores ≤7 admitted for acute neurological conditions.
  • Multivariate analysis of age, sex, and admission diagnosis (ischemic stroke, SIH, SH, anoxia, meningitis, PHI, closed head injury, tumors).

Main Results:

  • Out of 31,877 patients, 30% progressed to brain death (BD).
  • Women (36%) were more likely to evolve to BD than men (28%).
  • Spontaneous intracerebral hematoma (SIH), subarachnoid hemorrhage (SH), and penetrating head injury (PHI) significantly increased BD likelihood.

Conclusions:

  • Thirty percent of patients in the Glasgow 7 Program evolved to brain death.
  • Factors increasing the likelihood of BD include female sex, PHI, SH, and SIH.
  • These findings aid in refining patient selection for organ donation programs.