Med Bull Sisli Etfal Hosp. 2023; 57(4): 526-530 | DOI: 10.14744/SEMB.2023.65928

Retrospective Analysis of Patients Diagnosed with Brain Death in Our Hospital in the Last 15 Years

Murat Sahin¹, Mustafa Altinay¹, Ayse Surhan Cinar¹, Hanife Yavuz^2
1Department of Anaesthesia and Intensive Care, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye
²Department of Organ and Tissue Transplantation, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye

Objectives: Retrospective analysis of cases diagnosed with brain death in our hospital in the last 15 years.
Methods: The files and computer records of the cases diagnosed with brain death in the intensive care units of our hospital between January 2008 and January 2023 were evaluated retrospectively. The demographic data of the cases, the primary disease leading to brain death, the complementary tests used in the diagnosis of brain death, the day on which brain death was diagnosed in the intensive care unit, and the donor status were examined.
Results: A total of 228 cases diagnosed as brain death were detected. Seven patients with missing data were excluded from the study. 61.99% of the cases were male, 38.01% were female, 14.02% were under 18 years old, 68.34% were between 18 and 65 years old, 17.64% were over 65 years old. Brain death was diagnosed in 69.69% of the patients admitted to the intensive care unit in the first 7 days, 22.17% in 7–14 days, and 8.14% after 14 days. The primary disease causing brain death was found to be 47% hemorrhagic cerebral injury, 21% traumatic hemorrhagic injury, 18% ischemic cerebral injury, and 14% hypoxic cerebral injury. No ancillary testing was used in 38% of the cases. Carotid doppler ultrasound was used in 36%, computed tomography angiography was used in 22%, and transcranial doppler was used in 4%. Families agreed to be organ transplant donors in 28.95% of the cases. 71.05% family members refused to be organ transplant donors.
Conclusion: The number of organ donations and the diagnosis of brain death has decreased rapidly with the covid-19 pandemic. In order to increase organ donation, we think that the necessary education should be given at an early age to increase organ donation awareness and social awareness.

Keywords: Brain death, computed tomography angiography, organ donation, organ transplantation

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Son 15 Yýlda Hastanemizde Beyin Ölümü Tanýsý Almýþ Hastalarýn Retrospektif Analizi

Murat Sahin¹, Mustafa Altinay¹, Ayse Surhan Cinar¹, Hanife Yavuz^2
1Türkiye Saðlýk Bilimleri Üniversitesi, Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Anestezi ve Yoðun Bakým Kliniði, Ýstanbul
²Türkiye Saðlýk Bilimleri Üniversitesi, Þiþli Hamidiye Etfal Eðitim ve Araþtýrma Hastanesi, Organ ve Doku Nakil Kliniði, Ýstanbul

Amaç: Çalýþmamýzda hastanemizde son 15 yýlda beyin ölümü tanýsý almýþ olgularýn retrospektif incelenmesi.
Gereç ve Yöntem: Hastanemizin yoðun bakým ünitelerinde Ocak 2008 ile Ocak 2023 tarihleri arasýnda beyin ölümü tanýsý alan vakalarýn dosya ve bilgisayar kayýtlarý retrospektif olarak deðerlendi. Olgularýn demografik verileri, beyin ölümüne yol açan primer hastalýk, beyin ölümü tanýsýnda kullanýlan tamamlayýcý testler, yoðun bakýmda kaçýncý günde beyin ölümü tanýsý aldýðý ve donör durumlarý incelendi.
Bulgular: Beyin ölümü tanýsý alan toplam 228 vaka tespit edildi. Verileri eksik 7 hasta çalýþma dýþý býrakýldý. Vakalarýn %61.99’u erkek, %38.01’i kadýn, %14,02’si 18 yaþýn altýnda, %68.34’ü 18-65 yaþ arasýnda, %17,64’ü 65 yaþ üstü bulundu. Yoðun bakýma yatan vakalarýn %69,69 ‘u ilk 7 günde, %22,17’si 7-14 günde, %8,14’ü ise 14 günden sonra beyin ölümü tanýsý aldý. Beyin ölümüne neden olan primer hastalýk; %47 vaka hemorajik serebral hasar, %21 vaka travmatik hemorajik hasar, %18 vaka iskemik serebral hasar ve %14 vaka hipoksik serebral hasar olarak bulundu. Vakalarýn %38’inde yardýmcý test kullanmamýþtýr.%36’sýnda karotis doppler ultrason, %22’sinda BT anjiografi ve %4’ünde transkranial doppler kullanýldýðý saptandý. Vakalarýn %28,95’i organ nakli donörü olmasýný aileleri kabul etti. %71,05 aile yakýný organ nakli donörü olmasýný reddetti
Sonuç: Organ baðýþý sayýsý ve beyin ölümü tanýsý covid-19 pandemisiyle hýzlý bir düþüþ yaþamýþtýr. Organ baðýþýný arttýrmak için organ baðýþ bilincini ve toplumsal bilincin artmasý için gerekli eðitimlerin erken yaþlarda yapýlmasý gerektiðini düþünüyoruz. (SETB-2023-05-092)

Anahtar Kelimeler: Beyin ölümü, bigisayarlý tomografi anjiografi, organ baðýþý, organ nakli

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