Abstract 241: Organ Procurement Rates in a Statewide System of Cardiac Arrest Centers
Objectives: Prognostication after out-of-hospital cardiac arrest (OHCA) is difficult and many who regain a pulse but remain comatose on hospital arrival have care terminated in the emergency department (ED). While the introduction of therapeutic hypothermia (TH) as a beneficial post-arrest therapy is changing this practice, most OHCA victims still do not survive to hospital discharge. In addition to the survival benefits, admission for TH and further care might allow the process of organ donation to occur. We sought to describe the donation of organs in OHCA non-survivors in a statewide system of cardiac arrest centers (CACs).
Methods: Analysis of prospectively collected data on adult OHCA patients transported to a CAC, recognized by the state department of health. The categorical question of organ donation was documented by in-hospital personnel as part of a standardized post-arrest data tool and entered into a secure, statewide post-arrest care registry.
Results: There were 1,332 complete adult OHCA records evaluated from 26 CACs between 12/01/2007 and 12/01/2009. The average patient age was 61.0 years, 36.2% were female, and 20.6% had VF as the presenting rhythm in the field. Survival to discharge for those with return of spontaneous circulation (ROSC) in the ED was 225/344 (65%). Of the 1,107 OHCA patients who died, 219 (19.8%) were marked by hospital personnel as being an organ donor. State organ donor network data showed that on average, each organ donor selected provided 3.3 organs. This resulted in an estimated 719 organs donated in this cohort of OHCA patients during the 2 year period.
Conclusions: In addition to improving outcomes after OHCA, the practice of delaying neurologic prognostication in order to treat patients with TH may result in additional benefits to society through organ donation.
- © 2010 by American Heart Association, Inc.