Impact of compliance with the American College of Surgeons trauma center verification requirements on organ donation-related outcomes

Darren Malinoski, Madhukar S. Patel, Stephanie Lush, M. Lynn Willis, Sonia Navarro, Danielle Schulman, Tasha Querantes, Ramona Leinen-Duren, Ali Salim

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)186-192
Number of pages7
JournalJournal of the American College of Surgeons
Volume215
Issue number2
DOIs
StatePublished - Aug 2012
Externally publishedYes

Fingerprint

Tissue and Organ Procurement
Trauma Centers
Tissue Donors
Wounds and Injuries
Organizations
Brain Injuries
Guidelines
Process Assessment (Health Care)
Patient Admission
Surgeons
Craniocerebral Trauma
Nervous System
Registries
Outcome Assessment (Health Care)

Keywords

  • Abbreviated Injury Score
  • ACS
  • AIS
  • American College of Surgeons
  • catastrophic brain injury guideline
  • CBIG
  • DCDD
  • DNDD
  • donation after cardiac death
  • donation after neurologic determination of death
  • OPO
  • organ procurement organization

ASJC Scopus subject areas

  • Surgery

Cite this

Impact of compliance with the American College of Surgeons trauma center verification requirements on organ donation-related outcomes. / Malinoski, Darren; Patel, Madhukar S.; Lush, Stephanie; Willis, M. Lynn; Navarro, Sonia; Schulman, Danielle; Querantes, Tasha; Leinen-Duren, Ramona; Salim, Ali.

In: Journal of the American College of Surgeons, Vol. 215, No. 2, 08.2012, p. 186-192.

Research output: Contribution to journalArticle

Malinoski, Darren ; Patel, Madhukar S. ; Lush, Stephanie ; Willis, M. Lynn ; Navarro, Sonia ; Schulman, Danielle ; Querantes, Tasha ; Leinen-Duren, Ramona ; Salim, Ali. / Impact of compliance with the American College of Surgeons trauma center verification requirements on organ donation-related outcomes. In: Journal of the American College of Surgeons. 2012 ; Vol. 215, No. 2. pp. 186-192.
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T1 - Impact of compliance with the American College of Surgeons trauma center verification requirements on organ donation-related outcomes

AU - Malinoski, Darren

AU - Patel, Madhukar S.

AU - Lush, Stephanie

AU - Willis, M. Lynn

AU - Navarro, Sonia

AU - Schulman, Danielle

AU - Querantes, Tasha

AU - Leinen-Duren, Ramona

AU - Salim, Ali

PY - 2012/8

Y1 - 2012/8

N2 - 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.

AB - 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.

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KW - catastrophic brain injury guideline

KW - CBIG

KW - DCDD

KW - DNDD

KW - donation after cardiac death

KW - donation after neurologic determination of death

KW - OPO

KW - organ procurement organization

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