[Diagnosis of brain death in the admission department of the Neurologic Clinic of Erlangen University from 1984 to 1994].
OBJECTIVE
The reliable diagnosis of brain death is a precondition of organ removal for subsequent transplantation. As demographic data, information on the underlying cause and written consent to organ removal from brain-dead patients are largely unknown; protocols relating to the determination of brain death were analysed to obtain these data.


METHODS
The study was based on an examination of the protocols of 547 consecutive and unselected patients who between 1984 and 1994 had been examined for possible brain death by experienced members of the Neurological Department of Erlangen University, in consequence of the establishment of a consultation service for this purpose to hospitals in the region of North Bavaria. The criteria of brain death were those established by the Federal German Doctors' Chamber, all the data in the written protocol being analysed retrospectively.


RESULTS
Brain death was confirmed in 521 patients (319 males, 202 females; mean age 40.1 [1.5 - 84] years). 473 patients (86.5%) had been examined at the Erlangen University Clinic or the Municipal Hospital in Nuremberg, the remainder in regional hospitals. The most common causes were trauma to the head/brain (43.5%), subarachnoid haemorrhage (18.6%), generalised hypoxaemia (9.5%), cerebral infarction (7.3%) or other conditions (4.5%). 33 patients (6%) had committed suicide. Organs were removed in 244 of 413 patients (59.1%) for whom there data on possible organ removal: seven patients had carried donor cards, relatives' consent was obtained in 237. No consent was given in 90 cases (21.8%), while 79 (19.2%) were excluded for medical reasons.


CONCLUSIONS
If brain death is suspected, an experienced neurological consultant should be called in as soon as possible to assess the patients survival chances and evaluate possible organ removal for subsequent transplantation.
Heckmann
J G
JG
Neurologische Klinik, Universität Erlangen-Nürnberg.
Lang
C J
CJ
Hauser
I
I
Neundörfer
B
B
D000289:Admitting Department, Hospital; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001926:Brain Death / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D005260:Female; D005858:Germany; D006748:Hospital Departments; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009462:Neurology; D016377:Organ Transplantation / Q000592:standards*; D012017:Referral and Consultation; D014019:Tissue Donors / Q000706:statistics & numerical data; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence / Q000592:standards*
Hirntoddiagnostik im Einzugsbereich der Neurologischen Universitätsklinik Erlangen von 1984 bis 1994.