2013 - ISODP 2013 Congress
Mini-Oral 4 on Creating Change
11.8 - Admission to intensive care for consideration of organ donation in Australia and New Zealand
Presenter: Andrew, Melville, Melbourne, Australia
Authors: Andrew P Melville, David V Pilcher, Joanna Mitropoulos, Steve J Philpot
Admission to intensive care for consideration of organ donation in Australia and New Zealand
Andrew P Melville1, David V Pilcher1,2,3, Joanna Mitropoulos1, Steve J Philpot1,3
1Intensive Care Unit, Alfred Hospital, Melbourne, Australia, 2Australian & New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation, Melbourne, Australia, 3Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
ICU admission for consideration of organ donation remains controversial in some contexts. Limited data is available on the frequency and outcomes of this practice.
To define epidemiology of patients admitted to ICU for consideration of organ donation and identify factors associated with outcome.
Retrospective analysis of data from the Australian and New Zealand Intensive Care Society Adult Patient Database between 2007 and 2012.
Between 2007 and 2012, there were 467 admissions to ICU for consideration of organ donation (0.08% of total ICU admissions), and these numbers are increasing, with 118 in 2012. Median length of ICU stay was 25.7 hours (IQR 15.3-41.9). The most common diagnosis was intracerebral haemorrhage. Hospital mortality was 97.2%. 9 patients (1.9%) were discharged home and 4 (0.9%) to a chronic care or rehab facility. No data was available on the proportion that became organ donors. Factors independently associated with survival were increasing age (OR 1.05, 95% CI 1.01–1.10, p=0.012), not being intubated and ventilated (OR 8.1, 95% CI 2.2-29.8, p=0.002) and non-neurological diagnoses (OR 14.2, 95% CI 3.8–53.4, p<0.0001).
Admission to ICU for consideration of organ donation is an uncommon but increasing occurrence and most patients die. Non-neurological diagnoses were associated with survival.
More work is required to establish the accuracy of these results and extent of possible data error. Survival may represent a failure to identify patients appropriately and assessment of events during ICU stay and functional status of survivors is needed.
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