Extern Validation of a Predictive Score of Brain Death in Severe Stroke (DIAPASON1)

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    Central Hospital, Nancy, France
Updated on 22 January 2021
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There is currently a shortage of organ in France, for patients with chronic diseases who are on the waiting list for an organ. The first source of organ donor in France is patients with brain death. 58% of patients in brain death are patients with a severe stroke ( ischemic or hemorrhagic). In order to identify which patient with a severe stroke and with unfavorable prognosis who can evolve to brain death, we have conducted a retrospective study in Lorrain, in France, and we have built a predictive score of brain death in these patients. It is important to validate this predictive score in a prospective study on a greater scale than the first study.


Main objective :

External validation of a brain death evolution predictive score GRAHAL65 (initial Glasgow score 6, systolic blood pressure >150 mmHg, past history of alcohol abuse, herniation, hydrocephalus, and stroke volume>65 ml) for patients with severe stroke and withhold therapy built.

Secondary objectives :

Identification of other clinical and paraclinical predictive factors of brain death

  • Age,sex,
  • Temperature and glycemia
  • Rostro-caudal abolition of brainstem reflexes
  • Other cardiovascular risk factors (hypertension, diabetes, atrial fibrillation, dyslipidemia,)
  • Antiplatelet therapy, anticoagulant treatment,
  • Intravenous thrombolytic therapy or thrombectomy
  • Type of stroke
  • Infarct location
  • Type of brain herniation

Condition Cerebrovascular accident, Stroke, cerebrovascular accidents, strokes, cerebral
Clinical Study IdentifierNCT03612141
SponsorCentral Hospital, Nancy, France
Last Modified on22 January 2021


Yes No Not Sure

Inclusion Criteria

Patient aged 18 years and over
Patient with a sever stroke less than 48 hours diagnosed by brain imaging magnetic resonance imaging or computed tomography (including cerebral infarction, intra-parenchymal hemorrhage and subarachnoid haemorrhage
Patient with Glasgow Scale score <8 Engaged vital prognosis
Absence of therapeutic resources
Decision of resuscitation measures to protect the organs in the purpose organ donation after brain death

Exclusion Criteria

Pregnant woman
Patient with recent traumatic brain injuries (subdural hematoma, extradural hematoma and contusions)
Obvious contraindication of organ donation excluding the patient from organ protection measures in intensive care unit (expression of patient opposition, HIV infection, active tuberculosis, spongiform encephalopathy
human growth hormones treatment origin, rabies, active cancer)
Opposition of family member of the patient
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