Hartwig M S, Hall G, Hathaway D, Gaber A O
College of Graduate Health Sciences, University of Tennessee, Memphis.
Arch Surg. 1993 Dec;128(12):1331-5; discussion 1335.
To determine whether referral of potential organ donors is affected by race of the patient.
Retrospective chart audit.
Regional trauma center serving a 50% African-American population.
Records of patients meeting organ procurement organization criteria were reviewed for evidence that (1) they had been identified as a potential organ donor, (2) the family had been approached about organ donation, and (3) the family had agreed to or refused organ donation.
There were 620 deaths, 152 (24%) met all donor criteria, 114 (75%) were identified as potential donors, 90 (59%) were approached for donation, and 35 (23%) were organ donors. Of the white patients, 84% (71/85) vs 64% of the African-Americans (43/67) were identified as donors (P < .01); 69% (59) of the whites vs 46% (31) of the African-Americans were approached for donation (P < .01); and 28% (24) of the whites vs 16% (11) of the African-Americans were organ donors (P < .086).
Before and after controlling for cause of death, the risk that African-American donors would not be identified was more than 2.4 times greater than for whites (P < .01). No significant racial differences were noted in requests for suicide and homicide victims; for accident victims, significantly fewer requests were made of African-Americans. Efforts must be made to determine the dynamics of interaction between staff and donor families and to enhance health-care team members' abilities to identify donors and request donations from both races in stress-provoking situations.
确定潜在器官捐献者的转诊是否受患者种族的影响。
回顾性病历审核。
服务于50%为非裔美国人的地区创伤中心。
对符合器官获取组织标准的患者记录进行审查,以寻找以下证据:(1)他们已被确定为潜在器官捐献者;(2)已与家属探讨器官捐献事宜;(3)家属已同意或拒绝器官捐献。
共有620例死亡病例,152例(24%)符合所有捐献标准,114例(75%)被确定为潜在捐献者,90例(59%)被探讨是否捐献,35例(23%)为器官捐献者。白人患者中,84%(71/85)被确定为捐献者,而非裔美国人中这一比例为64%(43/67)(P < 0.01);白人中有69%(59例)被探讨是否捐献,而非裔美国人中这一比例为46%(31例)(P < 0.01);白人中有28%(24例)为器官捐献者,而非裔美国人中这一比例为16%(11例)(P < 0.086)。
在控制死亡原因前后,非裔美国捐献者未被识别的风险比白人高2.4倍以上(P < 0.01)。在针对自杀和凶杀受害者的请求方面未发现显著种族差异;对于意外事故受害者,向非裔美国人提出的请求明显较少。必须努力确定工作人员与捐献者家属之间互动的动态情况,并提高医疗团队成员在压力情境下识别捐献者并向两个种族请求捐献的能力。