Factors associated with the diagnosis of Brain Death in hospitals in the State of Sergipe

Santos, José Lucas dos; Cisneiros, Gabriella Santos; Oliveira, Jussiely Cunha; Santos, Eduesley Santana; Pinheiro, Fernanda Gomes de Magalhães Soares

doi:10.1590/1980-220X-REEUSP-2025-0014en

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Original Article • Rev. esc. enferm. USP 59 • 2025 • https://doi.org/10.1590/1980-220X-REEUSP-2025-0014en linkcopy

Factors associated with the diagnosis of Brain Death in hospitals in the State of Sergipe

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: To analyze the factors associated with the diagnosis of brain death (BD) in hospitals in the State of Sergipe, Brazil.

Method: Qualitative study based on the theoretical-methodological framework of French DiscouCross-sectional study carried out between 2023 and 2024 in four hospitals in Sergipe. Participants were over 18 years of age, of both sexes, with three points on the Glasgow Coma Scale, neurological injury confirmed by brain tomography and absence of at least two brainstem reflexes.

Results: The study included 69 participants and a higher prevalence of individuals from inland cities (65%), with median age of 52 years (42.0–68.0), female (59%), and of mixed ethnicity (62%) was observed. The main neurological causes were stroke and traumatic brain injury. Individuals in older age groups and individuals with cancer are less likely to have BD confirmed. The variable place of residence was significantly associated with the diagnosis.

Conclusion: Integration of well-defined institutional protocols, telehealth consultations, and professional training are recommended as strategies that can lead to faster, safer, and more equitable diagnosis in contexts of structural vulnerability.

DESCRIPTORS
Adult; Brain Death; Epidemiology; Diagnosis

Characteristics	N = 69
Age
Mean (Standard Deviation)	53.49 (17.29)
Median [25%;75%]	52.0 [42.0;68.0]
Sex, n/N (%)
Female	41/69 (59%)
Male	28/69 (41%)
Race, n/N (%)
White	16/64 (25%)
Black	9/64 (14%)
Brown	39/64 (61%)
Marital status, n/N (%)
Married	19/56 (34%)
Single	23/56 (41%)
Common law marriage	11/56 (20%)
Widower	3/56 (5%)
Level of education, n/N (%)
Elementary education	29/59 (49%)
High school	21/59 (36%)
Higher education	3/59 (5%)
Never studied	6/59 (10%)
Occupation, n/N (%)
Retired	23/69 (33%)
Self-employed	17/69 (25%)
Private company employee	11/69 (16%)
Civil servant	5/69 (7%)
Others	13/69 (19%)
Income, n/N (%)
Two to three minimum salaries	12/69 (17%)
Did not declare	19/69 (28%)
One salary	38/69 (55%)
Institution of collection, n/N (%)
H2	3/69 (4%)
H4	1/69 (1%)
H3	6/69 (9%)
H1	59/69 (86%)
Inpatient unit, n/N (%)
Yellow	3/69 (4%)
ICU	47/69 (68%)
Red	19/69 (28%)
Lifestyle, n/N (%)
Alcoholism	13/61 (21%)
Sedentary lifestyle	31/61 (51%)
Smoking	12/61 (20%)
Denies	3/61 (5%)
Others	2/61 (3%)
SAH, n/N (%)
No	14/47 (30%)
Yes	33/47 (70%)
DM, n/N (%)
No	32/47 (68%)
Yes	15/47 (32%)
Cancer, n/N (%)
No	44/47 (94%)
Yes	3/47 (6%)
Cardiovascular, n / N (%)
No	41/47 (87%)
Yes	6/47 (13%)

Characteristics	Crude		Adjusted		Multivariate
	PR1 (95% CI)2	p value	PR (CI 95%)	p value	PR (CI 95%)	p value
Age	0.97 (0.94–1.00)	0.055	0.96 (0.92–1.00)	0.066	0.96 (0.92–1.00)	0.044
Place of Residence
Other cities	–		–		–
Greater Aracaju	5.38 (1.48–19.6)	0.011	5.49 (1.32–32.0)	0.031	5.26 (1.37–27.2)	0.025
Cancer
No	–		–		–
Yes	0.49 (0.17–1.45)	0.199	0.18 (0.04–0.73)	0.022	0.20 (0.04–0.78)	0.027

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Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[T1FN1] Legend: n – Absolute frequency; N – Valid data; % – Percentage; SAH – Systemic Arterial Hypertension; DM – Diabetes Mellitus; ICU – Intensive Care Unit; H1 – Emergency Hospital; H2 – Philanthropic Hospital; H3 – University Hospital; H4 –General Hospital.