Impact of Compliance with the American College of Surgeons Trauma Center Verification Requirements on Organ Donation-Related Outcomes - 21/07/12
, Madhukar S. Patel, ScM c, Stephanie Lush, RN, MSN c, M. Lynn Willis, MHA c, Sonia Navarro b, Danielle Schulman, MPH a, Tasha Querantes, MBA b, Ramona Leinen-Duren b, Ali Salim, MD, FACS a
Correspondence address: Darren J Malinoski, MD, FACS, Cedars-Sinai Medical Center, 8635 West 3rd St, Suite 665w, Los Angeles, CA 90048Résumé |
Background |
In order to maximize organ donation opportunities, the American College of Surgeons (ACS) requires verified trauma centers to have a relationship with an organ procurement organization (OPO), a policy for notification of the OPO, a process to review organ donation rates, and a protocol for declaring neurologic death. We hypothesized that meeting the ACS requirements will be associated with improved donation outcomes.
Study Design |
Twenty-four ACS-verified Level I and Level II trauma centers were surveyed for the following registry data points from 2004 to 2008: admissions, ICU admissions, patients with a head Abbreviated Injury Score ≥ 5, deaths, and organ donors. Centers were also queried for the presence of the ACS requirements as well as other process measures and characteristics. The main outcomes measure was the number of organ donors per center normalized for patient volume and injury severity. The relationship between center characteristics and outcomes was determined.
Results |
Twenty-one centers (88%) completed the survey and referred 2,626 trauma patients to the OPO during the study period, 1,008 were eligible to donate, and 699 became organ donors. Compliance with the 4 ACS requirements was not associated with increased organ donation outcomes. However, having catastrophic brain injury guidelines (CBIGs) and the presence of a trauma surgeon on a donor council were associated with significantly more organ donors per 1,000 trauma admissions (6.3 vs 4.2 and 6.0 vs 4.2, respectively, p < 0.05).
Conclusions |
Although the ACS trauma center organ donation-related requirements were not associated with improved organ donor outcomes, involvement of trauma surgeons on donor councils and CBIGs were and should be encouraged. Additionally, incorporation of quantitative organ donation measures into the verification process should be considered.
Le texte complet de cet article est disponible en PDF.Abbreviations and Acronyms : ACS, AIS, CBIG, DCDD, DNDD, OPO
Plan
| Supported, in part, by the National Institute of Diabetes and Digestive and Kidney Diseases grant number 5RO1DK079667. Additionally, this work was supported in part by Health Resources and Services Administration contract 234-2005-37011C. The content is the responsibility of the authors alone and does not necessarily reflect the views or policies of the Department of Health and Human Services, nor does mention of trade names, commercial products, or organizations imply endorsement by the US Government. |
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| Disclosure Information: Nothing to disclose. |
Vol 215 - N° 2
P. 186-192 - août 2012 Retour au numéro
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