10 Years of Implementation of the “Glasgow 7” Quality Guarantee Program in the Mendoza Central Hospital: Epidemiology and Evolution of Neurocrytic Patients

• Published in: Transplantation proceedings 2020-05, Vol.52 (4), p.1053-1055
• Main Authors: Aldunate, Daniela, Santarelli, Virginia Soledad, Hidalgo, Gabriela
• Format: Article
• Language: English
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2020.02.001

In 2003, the Glasgow 7 Quality Guarantee Program was put into effect in Argentina with the objective of standardizing the donation and transplant process throughout the country, establishing the observation and registration of all neurocritical patients with a score on the Glasgow Coma Scale of 7 of 15 or less admitted to critical beds of selected establishments. The following study is retrospective, observational, and cohort-based. It was developed in the Central Hospital of Mendoza, in the critical units, including guard, coronary, cardiovascular surgery recovery, and intensive care therapy. The inclusion criteria were admission to the institution with a score on the Glasgow Coma Scale of 7 or less with a structural cause of coma. Data collection was carried out in the national online database SINTRA. From January 1, 2008, to December 31, 2018, 1757 patients were enrolled at the Central Hospital of Mendoza, Argentina with Glasgow scores of 7 or less. The most frequent cause of coma was brain trauma (934 patients; 53%), followed by stroke (614 patients; 35%). Of those who scored 3 of 15 in the GCS upon admission, 65% progressed to brain death, whereas 72% of those who scored 7 were discharged. Of all these patients, 270 became donors, accounting for 43% of all brain deaths, whereas 187 had refused to become organ donors (30.6%). Of the total real donors, 55% were multiorganic (150 donors). •The most common cause of Glasgow Coma Scale score less than 7 is brain trauma, due to car accidents. Brain trauma related to car accidents represents 70% of all patients admitted with traumatic brain injury.•The patients who arrived at the hospital with a low score on the Glasgow Coma Scale were those who died most frequently, both by cardiac arrest and brain death.•Among patients who experienced brain death, 43% were 50 to 59 years old.•Of all the registered processes, 43% evolve favorably and were discharged from the ICU, 35% get diagnosed brain death and the rest (21%) died due to cardiorespiratory arrest. This results settles the good quality of neurocritical care in the institution.