title: [Computed tomography as a tool to detect potential brain-dead donors].
abstract: OBJECTIVE
  To assess the ability of urgent head computed tomography (CT) scan screening to detect patients who can evolve to brain death (BD).
  
  
  METHODS
  Patients who underwent urgent head CT scan and meet the following criteria: midline shift greater than 5mm and/or decrease or absence of basal cisterns. A follow-up for 28 days of each patient was made. Epidemiological data (sex, age, cause of brain injury), clinical data (level of consciousness, severity index in the CT) and patient outcomes (death, BD, discharge or transfer) were recorded. This was a prospective observational study.
  
  
  RESULTS
  One hundred and sixty-six patients were selected for study, with mean age 60.08 (SD 21.8) years. A percentage of 49.4 were men and the rest women. In the follow-up, 20,5% (n=34) had BD. In univariate analysis, intracerebral hemorrhage, Glasgow Coma Scale score less than 8 and alteration of basal cisterns were statistically significant in predicting BD (P<.05). Multivariate analysis showed that patients with compression of basal cisterns were 20 (95% confidence interval [95% CI] 2.61 to 153.78; P=.004] times more likely to progress to brain death, while the absence there of 62.6 (95% CI 13.1 to 738.8; P<.001] times more.
  
  
  CONCLUSIONS
  Our work shows that data as easy to interpret as compression/absence of basal cisterns can be a powerful tool for screening patients at risk for progression to BD.
authors.affiliation: Hospital Universitario Virgen del Rocío, Sevilla, España. Electronic address: jaume.revuelto.sspa@juntadeandalucia.es.
authors.forename: Jaume
authors.initials: J
authors.lastname: Revuelto-Rey
authors.affiliation: Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Teresa
authors.initials: T
authors.lastname: Aldabó-Pallás
authors.affiliation: Hospital Universitario Virgen del Rocío, Sevilla, España; Instituto de Biomedicina de Sevilla/Centro Superior de Investigaciones Científicas, Universidad de Sevilla, Sevilla, España.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Egea-Guerrero
authors.affiliation: Instituto de Biomedicina de Sevilla/Centro Superior de Investigaciones Científicas, Universidad de Sevilla, Sevilla, España; Departamento de Medicina Preventiva y Salud Pública, Universidad de Sevilla, Sevilla, España.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Vilches-Arenas
authors.affiliation: Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Enrique Javier
authors.initials: EJ
authors.lastname: Lara
authors.affiliation: Hospital Universitario Virgen del Rocío, Sevilla, España.
authors.forename: Elena
authors.initials: E
authors.lastname: Gordillo-Escobar
mesh_terms: D000328:Adult; D000368:Aged; D001926:Brain Death / Q000175:diagnosis*; D001929:Brain Edema / Q000000981:diagnostic imaging / Q000401:mortality; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000401:mortality; D002545:Brain Ischemia / Q000000981:diagnostic imaging / Q000401:mortality; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000401:mortality; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013346:Subarachnoid Space / Q000000981:diagnostic imaging*; D015599:Trauma Severity Indices
keywords: Brain death; Donación; Donation; Head computed tomography scan; Muerte encefálica; Tomografía computarizada de cráneo