R.Ibar, C.Soratti, M.Torres

A Quality Assurance Program in the procurement process that includes the monitoring of neurocritical patients with GCS ≤7 was implemented in 2003, and improved brain death (BD) detection in Argentina. Background

Organ donor rate pmp increased in Argentina

Objectives To analyze the group, identifying various factors: mortality, causes of death, age, Glasgow at admission, differences among provinces and hospitals.

Material and methods A retrospective study using the SINTRA database. The evolution of 18,224 patients between January 1, 2006, and December 31, 2010, was analyzed. Protocol possible outcomes were: out of Protocol for Glasgow improvement, or death by either Cardiac Arrest (CA) or BD.

Causes of coma

Outcomes

 Differences among Province Mortality rate in GCS 7

Differences among hospitals

BD or CA?

Results Argentina mortality in G≤7 patients included in this program was 70% (12,678). 5,688 presented CA (45%) and 6,990 BD (55%). Mortality in G3 admitted patients was 88%. Gunshot injuries mortality: 83%, subarachnoid hemorrhage and hemorrhagic stroke: 82%. Mortality rate varies among different provinces. There are also significant differences among hospitals, but it is noteworthy that in the 10 hospitals that generated more actual donors, mortality was 60%, 10 points below the total analyzed.

Conclusion We emphasize the importance of constantly improving the care of neurocritical patients, trying to lower the high mortality rate. In addition, the group of patients with fatal neurological injuries may develop BD instead of CA. This is a quality indicator of Intensive Care Units with a direct impact on organ donor generation.

Take home message A quality program combined with an Informatic system as SINTRA will provide significant information to detect the critical points in the donation process, leading to actions for better organ generation.

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