Variability across countries for brain death determination in adults.
Brain Inj
; 37(6): 461-467, 2023 05 12.
Article
in En
| MEDLINE
| ID: mdl-36803124
ABSTRACT
BACKGROUND:
The guidelines of brain death determination vary across countries. Our aim was to compare diagnostic procedures of brain death determination in adults among five countries.METHOD:
Consecutive comatose patients who received brain death determination from June 2018 to June 2020 were included. The technical specifications, completion rates and positive rates of brain death determination according to criteria of different countries were compared. The accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of each ancillary test for the identification of brain death diagnosed according to different criteria were investigated.RESULTS:
One hundred and ninety nine patients were included in this study. One hundred and thirty one (65.8%) patients were diagnosed with brain death according to French criteria, 132 (66.3%) according to Chinese criteria, and 135 (67.7%) according to criteria of USA, UK and Germany. The sensitivity and PPV of electroencephalogram (92.2% - 92.3%) and somatosensory evoked potential (95.5% - 98.5%) were higher than transcranial Doppler (84.3% - 86.0%).CONCLUSIONS:
The criteria of brain death in China and France are comparatively stricter than in USA, UK and Germany. The discrepancy in brain death determination between clinical assessments and additional confirmation of ancillary tests is small.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Brain
/
Brain Death
Type of study:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Limits:
Adult
/
Humans
Language:
En
Journal:
Brain Inj
Journal subject:
CEREBRO
Year:
2023
Type:
Article
Affiliation country:
China