Analysis of deaths within 24 hours of injury: cost-benefit implications for organ and tissue donations

• Published in: The journal of trauma Vol. 40; no. 4; p. 632
• Main Authors: Malangoni, M A, Mancuso, C, Jacobs, D G, Luebke, D, Fallon, W F, McHenry, C R
• Format: Journal Article
• Language: English
• Published: United States 01.04.1996
• Subjects: Adult; Cost-Benefit Analysis; Female; Hospital Charges; Hospital Mortality; Humans; Male; Retrospective Studies; Tissue and Organ Procurement - economics; Tissue Donors; Trauma Severity Indices; Wounds and Injuries - classification; Wounds and Injuries - economics; Wounds and Injuries - mortality
• ISSN: 0022-5282
• DOI: 10.1097/00005373-199604000-00019

To determine useful predictors of successful organ donation in patients who die within 24 hours of injury (early deaths). Retrospective review of a 3-year experience at a Metropolitan Level I Trauma Center. All 223 early deaths among 5,719 trauma patients in a 3-year period were reviewed. This group represented 62% of all trauma deaths. 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 < 0.001). There were no organ donors among victims >65 years old or in 64 of 65 patients with a Revised Trauma Score of <2.2. The Revised Trauma Score was significantly higher in organ donors (3.39 vs. 3.07, p < 0.05). The cost-benefit ratio for early deaths was $6,512 per organ/tissue recovered. 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.