Reinforcing the facts on the somatic survival of brain dead patients through an observational study at Qatar

Abstract

Reinforcing the facts on the somatic survival of brain dead patients through an observational study at Qatar Saibu George, Merlin Thomas, Ahmed Abdussalam, Tasleem Raza, Husain Ali, Shafeeq Thappy Hamad General Hospital, Qatar Background/Purpose: Brain death implies the permanent absence of cerebral and brainstem functions. Death of the brain therefore qualifies as death, as the brain is essential for integrating critical functions of the body and the body is reduced to a mere collection of organs. Although this is legally accepted at Qatar, cultural norms prevent its clinical application. Methods: Retrospective analysis of brain dead patients admitted to intensive care units at a large urban government hospital at Qatar over a 10-year period from 2003 was done. Results: Fifty-three patients meeting the brain dead criteria were included in the study. Twenty-six percent of the patients were from Arab countries, and 81% of the patients were males. One patient with somatic survival of 395 days post–cardiac arrest from status asthmaticus, being an outlying variable, was excluded from analysis. Mean duration of somatic survival was 4.5 days, and the median, 3 days. The most common etiology was hemorrhagic stroke (45.3%) followed by ischemic stroke (17%). Ischemic stroke patients had the longest median survival of 11 days. Organ donation was accepted only by 3.7% of patients. Conclusions: The average somatic survival of brain dead patient is less than a week irrespective of supportive measures provided. Brain death is not immediately followed by cessation of other homeostatic mechanisms. Health care expenditures must include the somatic survival data, as intensive care is required. Public education on brain death will assist to incorporate withdrawal of care as a management option and enhance organ donation.