ANALYSIS OF DEATHS WITHIN 24 HOURS OF INJURY - COST-BENEFIT IMPLICATIONS FOR ORGAN AND TISSUE DONATIONS

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 5,71 9 trauma patients in a 3-year period were reviewed. This group represe nted 62% of all trauma deaths. Results: Forty-six patients (21%) donat ed 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 o r in 64 of 65 patients with a Revised Trauma Score of <2.2. The Revise d 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 or gan/tissue recovered. Conclusions: Decisions regarding the resuscitati on of trauma patients who have characteristics associated with a recog nized low rate of organ donation should be made exclusive of the poten tial for organ recovery.