Association of emergency intensive care unit occupancy due to brain-dead organ donors with ambulance diversion
Abstract Our study aims to explore how intensive care unit (ICU) occupancy by brain-dead organ donors affects emergency ambulance diversions. In this retrospective, single-center study at an emergency ICU (EICU), brain-dead organ donors were managed until organ procurement. We classified each day be...
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Nature Portfolio
2025-04-01
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| Online Access: | https://doi.org/10.1038/s41598-025-97198-7 |
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| author | Tetsuya Yumoto Takafumi Obara Takashi Hongo Tsuyoshi Nojima Kohei Tsukahara Masaki Hisamura Atsunori Nakao Takashi Yorifuji Hiromichi Naito |
| author_facet | Tetsuya Yumoto Takafumi Obara Takashi Hongo Tsuyoshi Nojima Kohei Tsukahara Masaki Hisamura Atsunori Nakao Takashi Yorifuji Hiromichi Naito |
| author_sort | Tetsuya Yumoto |
| collection | DOAJ |
| description | Abstract Our study aims to explore how intensive care unit (ICU) occupancy by brain-dead organ donors affects emergency ambulance diversions. In this retrospective, single-center study at an emergency ICU (EICU), brain-dead organ donors were managed until organ procurement. We classified each day between August 1, 2021, and July 31, 2023, as either an exposure day (any day with a brain-dead organ donor in the EICU from admission to organ procurement) or a control day (all other days). The study compared these days and used multiple logistic regression analysis to assess the impact of EICU occupancy by brain-dead organ donors on ambulance diversions. Over two years, 6,058 emergency patients were transported by ambulance, with 1327 admitted to the EICU, including 13 brain-dead organ donors. Brain-dead donors had longer EICU stays (17 vs. 2 days, P < 0.001). With 168 exposure and 562 control days, EICU occupancy was higher on exposure days (75% vs. 67%, P = 0.003), leading to more ambulance diversions. Logistic regression showed exposure days significantly increased ambulance diversions, with an odds ratio of 1.79 (95% CIs 1.10–2.88). This study shows that managing brain-dead organ donors in the EICU leads to longer stays and higher occupancy, resulting in more frequent ambulance diversions. These findings highlight the critical need for policies that optimize ICU resource allocation while maintaining the infrastructure necessary to support organ donation programs and ensuring continued care for brain-dead donors, who play an essential role in addressing the organ shortage crisis. |
| format | Article |
| id | doaj-art-152fceca61614db980b878c3d7ed6048 |
| institution | DOAJ |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-152fceca61614db980b878c3d7ed60482025-08-20T03:10:12ZengNature PortfolioScientific Reports2045-23222025-04-011511810.1038/s41598-025-97198-7Association of emergency intensive care unit occupancy due to brain-dead organ donors with ambulance diversionTetsuya Yumoto0Takafumi Obara1Takashi Hongo2Tsuyoshi Nojima3Kohei Tsukahara4Masaki Hisamura5Atsunori Nakao6Takashi Yorifuji7Hiromichi Naito8Department of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityDepartment of Epidemiology, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama UniversityDepartment of Emergency, Critical Care, and Disaster Medicine, Faculty of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama UniversityAbstract Our study aims to explore how intensive care unit (ICU) occupancy by brain-dead organ donors affects emergency ambulance diversions. In this retrospective, single-center study at an emergency ICU (EICU), brain-dead organ donors were managed until organ procurement. We classified each day between August 1, 2021, and July 31, 2023, as either an exposure day (any day with a brain-dead organ donor in the EICU from admission to organ procurement) or a control day (all other days). The study compared these days and used multiple logistic regression analysis to assess the impact of EICU occupancy by brain-dead organ donors on ambulance diversions. Over two years, 6,058 emergency patients were transported by ambulance, with 1327 admitted to the EICU, including 13 brain-dead organ donors. Brain-dead donors had longer EICU stays (17 vs. 2 days, P < 0.001). With 168 exposure and 562 control days, EICU occupancy was higher on exposure days (75% vs. 67%, P = 0.003), leading to more ambulance diversions. Logistic regression showed exposure days significantly increased ambulance diversions, with an odds ratio of 1.79 (95% CIs 1.10–2.88). This study shows that managing brain-dead organ donors in the EICU leads to longer stays and higher occupancy, resulting in more frequent ambulance diversions. These findings highlight the critical need for policies that optimize ICU resource allocation while maintaining the infrastructure necessary to support organ donation programs and ensuring continued care for brain-dead donors, who play an essential role in addressing the organ shortage crisis.https://doi.org/10.1038/s41598-025-97198-7Ambulance diversionBed occupancyBrain deathEmergency medical servicesIntensive care unitsOrgan donation |
| spellingShingle | Tetsuya Yumoto Takafumi Obara Takashi Hongo Tsuyoshi Nojima Kohei Tsukahara Masaki Hisamura Atsunori Nakao Takashi Yorifuji Hiromichi Naito Association of emergency intensive care unit occupancy due to brain-dead organ donors with ambulance diversion Scientific Reports Ambulance diversion Bed occupancy Brain death Emergency medical services Intensive care units Organ donation |
| title | Association of emergency intensive care unit occupancy due to brain-dead organ donors with ambulance diversion |
| title_full | Association of emergency intensive care unit occupancy due to brain-dead organ donors with ambulance diversion |
| title_fullStr | Association of emergency intensive care unit occupancy due to brain-dead organ donors with ambulance diversion |
| title_full_unstemmed | Association of emergency intensive care unit occupancy due to brain-dead organ donors with ambulance diversion |
| title_short | Association of emergency intensive care unit occupancy due to brain-dead organ donors with ambulance diversion |
| title_sort | association of emergency intensive care unit occupancy due to brain dead organ donors with ambulance diversion |
| topic | Ambulance diversion Bed occupancy Brain death Emergency medical services Intensive care units Organ donation |
| url | https://doi.org/10.1038/s41598-025-97198-7 |
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