Neuroanaesthesia & neurocritical care
Temporal changes in clinical practices for patients considered clinically brain dead: a single-center cohort study
Authors' conclusion
The opportunity for organ donation discussion increased over time among patients considered clinically brain dead, while the proportion of families consenting to donation remained relatively stable. This increase occurred alongside the progressive development of structured multidisciplinary processes, although their contribution to the observed temporal trend cannot be determined from this descriptive study.
Study context
- Population
- Patients considered clinically brain dead in the Emergency ICU of Okayama University Hospital between January 2017 and December 2025
- Participants
- 128 eligible patients
- Exposure
- Temporal changes by calendar year, with three study phases (2017-2019, 2020-2022, and 2023-2025) used for descriptive presentation
- Outcome
- Organ donation discussed with the families
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
Families with whom organ donation was discussed
110
85.9%
Of those whose families were approached, subsequently underwent organ donation after brain death
41
37.3%
Observational data: associations, not effects.
Further findings
| Outcome | OR per year (95% CI) | P value | |
|---|---|---|---|
| Corticosteroid useIncreasing | 1.64 (1.34–2.01) | P < 0.001 | |
| Likelihood of organ donation discussionIncreased significantly over time | 1.44 (1.17–1.79) | P = 0.001 | |
| Likelihood of organ donation discussion, restricted to patients in whom discussion was considered feasible (sensitivity analysis)Sensitivity analysis | 2.11 (1.42–3.15) | P < 0.001 | |
| 0.20.5125Odds ratio per year (log scale) |
Timing of corticosteroid and vasopressin initiation
- Earlier initiation of corticosteroids and vasopressin over calendar years
Vasopressin use; timing of determination of a brain-death-compatible state; timing of the initial organ donation discussion
- No significant trends
Original publication
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