title: Analysis of deaths within 24 hours of injury: cost-benefit implications for organ and tissue donations.
abstract: OBJECTIVE
  To determine useful predictors of successful organ donation in patients who die within 24 hours of injury (early deaths).
  
  
  METHODS
  Retrospective review of a 3-year experience at a Metropolitan Level I Trauma Center.
  
  
  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 < 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.
  
  
  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.
authors.affiliation: Department of Surgery, Case Western Reserve University School of Medicine, Cleveland, OH 44109-1998, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Malangoni
authors.forename: C
authors.initials: C
authors.lastname: Mancuso
authors.forename: D G
authors.initials: DG
authors.lastname: Jacobs
authors.forename: D
authors.initials: D
authors.lastname: Luebke
authors.forename: W F
authors.initials: WF
authors.lastname: Fallon
authors.forename: C R
authors.initials: CR
authors.lastname: McHenry
mesh_terms: D000328:Adult; D003362:Cost-Benefit Analysis; D005260:Female; D017722:Hospital Charges; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000191:economics*; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000145:classification* / Q000191:economics / Q000401:mortality