Analysis of deaths within 24 hours of injury: cost-benefit implications for organ and tissue donations
Malangoni, M.A.; Mancuso, C.; Jacobs, D.G.; Luebke, D.; Fallon, W.F.; McHenry, C.R.
Journal of Trauma 40(4): 632-635
1996
ISSN/ISBN: 0022-5282 PMID: 8614045 Document Number: 464580
Objective: To determine useful predictors of successful organ donation in patients who die within 24 hours of injury (early deaths). Design: Retrospective review of a 3-year experience at a Metropolitan Level I Trauma Center. Materials and Methods: All 223 early deaths among 5,719 trauma patients in a 3-year period were reviewed. This group represented 62% of all trauma deaths. Results: Forty-six patients (21%) donated 102 vascularized organs and made 66 donations of tissues. Patients with isolated severe head injuries had the highest rate of successful donation (33%). Those with severe head injury and another severe organ injury had a lower rate of donation (13%), and donation was rare (1%) among patients with severe organ injury in the absence of head injury (p lt 0.001). There were no organ donors among victims gt 65 years old or in 64 of 65 patients with a Revised Trauma Score of lt 2.2. The Revised Trauma Score was significantly higher in organ donors (3.39 vs. 3.07, p lt 0.05). The cost-benefit ratio for early deaths was 6,512 per organ/tissue recovered. Conclusions: Decisions regarding the resuscitation of trauma patients who have characteristics associated with a recognized low rate of organ donation should be made exclusive of the potential for organ recovery.