Evidence map›Paper›PMID 29946966›Full record

ArticleActa neurochirurgica2018

Identification of potential organ donors after aneurysmal subarachnoid hemorrhage in a population-based neurointensive care in Eastern Finland.

Olli-Pekka Kämäräinen, Jukka Huttunen, Antti Lindgren, Maarit Lång, Stepani Bendel, Ari Uusaro, Ilkka Parviainen, Timo Koivisto, Helena Isoniemi, Juha E Jääskeläinen

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In one paragraph

Article in Acta neurochirurgica, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Olli-Pekka KämäräinenNeurosurgery of KUH NeuroCenter, Kuopio University Hospital, PB 1777, 70211, Kuopio, Finland. olli-pekka.kamarainen@kuh.fi.
Jukka HuttunenNeurosurgery of KUH NeuroCenter, Kuopio University Hospital, PB 1777, 70211, Kuopio, Finland.
Antti LindgrenNeurosurgery of KUH NeuroCenter, Kuopio University Hospital, PB 1777, 70211, Kuopio, Finland.
Maarit LångInstitute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Stepani BendelInstitute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Ari UusaroInstitute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Ilkka ParviainenInstitute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
Timo KoivistoNeurosurgery of KUH NeuroCenter, Kuopio University Hospital, PB 1777, 70211, Kuopio, Finland.
Helena IsoniemiTransplantation and Liver Surgery Clinic, Abdominal Center, Helsinki University Hospital, Helsinki, Finland.
Juha E JääskeläinenNeurosurgery of KUH NeuroCenter, Kuopio University Hospital, PB 1777, 70211, Kuopio, Finland.
Kuopio University Hospital · FIUniversity of Eastern Finland · FIUniversity of Helsinki · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo analyze the organ donation action in population-based neurointensive care of acute aneurysmal subarachnoid hemorrhage (aSAH) and to seek factors that would improve the identification of potential organ donors (PODs) and increase the donor conversion rate (DCR) after aSAH.

methodsThe Kuopio Intracranial Aneurysm Database, prospective since 1995, includes all aSAH patients admitted to the Kuopio University Hospital (KUH) from its defined Eastern Finnish catchment population. We analyzed 769 consecutive acute aSAH patients from 2005 to 2015, including their data from the Finnish Transplantation Unit and the national clinical registries. We analyzed PODs vs. actual donors among the 145 (19%) aSAH patients who died within 14 days of admission. Finland had implemented the national presumed consent (opt-out) within the study period in the end of 2010.

resultsWe retrospectively identified 83 (57%) PODs while only 49 (34%) had become actual donors (total DCR 59%); the causes for non-donorship were 15/34 (44%) refusals of consent, 18/34 (53%) medical contraindications for donation, and 1/34 (3%) failure of recognition. In 2005-2010, there were 11 refusals by near relatives with DCR 52% (29/56) and only three in 2011-2015 with DCR 74% (20/27). Severe condition on admission (Hunt and Hess grade IV or V) independently associated with the eventual POD status.

conclusionsNearly 20% of all aSAH patients acutely admitted to neurointensive care from a defined catchment population died within 14 days, almost half from cardiopulmonary causes at a median age of 69 years. Of all aSAH patients, 11% were considered as potential organ donors (PODs). Donor conversion rate (DCR) was increased from 52 to 74% after the national presumed consent (opt-out). Implicitly, DCR among aSAH patients could be increased by admitting them to the intensive care regardless of dismal prognosis for the survival, along a dedicated organ donation program for the catchment population.

Indexed as

AdultAgedFemaleFinlandHumansIntensive Care UnitsIntracranial AneurysmMaleMiddle AgedMortalityRegistriesSubarachnoid HemorrhageTissue DonorsBrain deathIntensive careIntracranial aneurysmOrgan donationPotential organ donorSubarachnoid hemorrhage

Identifiers

PMID29946966
PMCPMC6060906
OpenAlexW2810546400

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.