Ma. Malangoni et al., ANALYSIS OF DEATHS WITHIN 24 HOURS OF INJURY - COST-BENEFIT IMPLICATIONS FOR ORGAN AND TISSUE DONATIONS, The journal of trauma, injury, infection, and critical care, 40(4), 1996, pp. 632-635
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.