MORTALITY PROFILE OF PATIENTS DECLARED AS BRAIN STEM DEAD IN RSUP DR. SARDJITO YEAR 2014-2022
Abstract
ABSTRACT
Brain stem death, characterized by the irreversible cessation of all brain and brain stem activity, presents clinically with deep coma, absence of brain stem reflexes, and apnea. Despite its critical significance in clinical and ethical decision-making, research on brain stem death in Indonesia remains limited. This study aims to describe the mortality profile of patients declared brain stem dead at RSUP Dr. Sardjito from 2014 to 2022, focusing on demographic characteristics, case distribution, management patterns, and documentation practices. A descriptive observational study with a cross-sectional design was conducted using retrospective data from medical records. Of 73 patients with traumatic brain injury (TBI) admitted to the ICU and requiring ventilator support, five (6.85%) were formally declared brain stem dead, one was recorded as suspected (1.4%), and only one had brain stem death documented as the official cause of death (1.4%). None of the cases exhibited direct structural lesions of the brain stem. The mean ICU length of stay was 5.2 days. All declarations followed standardized procedures involving confirmation by both anesthesiologist and neurologist. These findings suggest that brain stem death is a rare but significant outcome of severe TBI and highlight the need for timely intervention and improved documentation to guide future clinical and policy approaches.
ABSTRAK
Kematian batang otak, yang ditandai dengan berhentinya seluruh aktivitas otak dan batang otak secara ireversibel, secara klinis ditunjukkan oleh koma dalam, tidak adanya refleks batang otak, dan apnea. Meskipun memiliki signifikansi yang krusial dalam pengambilan keputusan klinis dan etis, penelitian mengenai kematian batang otak di Indonesia masih sangat terbatas. Penelitian ini bertujuan untuk menggambarkan profil mortalitas pasien yang dinyatakan meninggal secara batang otak di RSUP Dr. Sardjito selama periode 2014 hingga 2022, dengan fokus pada karakteristik demografis, distribusi kasus, pola penatalaksanaan, dan praktik dokumentasi. Penelitian ini merupakan studi observasional deskriptif dengan desain potong lintang menggunakan data retrospektif dari rekam medis. Dari 73 pasien dengan cedera otak traumatik (TBI) yang dirawat di ICU dan menggunakan ventilator, lima pasien (6,85%) secara resmi dinyatakan meninggal batang otak, satu pasien tercatat sebagai suspek (1,4%), dan hanya satu kasus yang mencantumkan kematian batang otak sebagai penyebab resmi kematian (1,4%). Tidak ada kasus yang menunjukkan lesi struktural langsung pada batang otak. Rerata lama perawatan di ICU adalah 5,2 hari. Seluruh deklarasi kematian batang otak dilakukan sesuai prosedur standar dengan konfirmasi oleh spesialis anestesi dan neurologi. Temuan ini menunjukkan bahwa kematian batang otak merupakan kejadian langka namun signifikan akibat TBI berat, serta menekankan pentingnya intervensi dini dan perbaikan dokumentasi untuk mendukung praktik klinis dan kebijakan di masa depan.
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