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Dublin Core
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Title
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November 2022 List
Text
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November 2022 List
URL Address
<a href="http://doi.org/10.1097/cce.0000000000000764" target="_blank" rel="noreferrer noopener"> http://doi.org/10.1097/cce.0000000000000764</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Predicting Time to Death After Withdrawal of Life-Sustaining Treatment in Children
Publisher
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Critical Care Explorations
Date
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2022
Subject
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Decision Support Techniques; Intensive Care Unit; Machine Learning; Pediatric; Terminal Care; Tissue and Organ Procurement
Creator
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Winter MC; Ledbetter DR
Description
An account of the resource
Accurately predicting time to death after withdrawal of life-sustaining treatment is valuable for family counseling and for identifying candidates for organ donation after cardiac death. This topic has been well studied in adults, but literature is scant in pediatrics. The purpose of this report is to assess the performance and clinical utility of the available tools for predicting time to death after treatment withdrawal in children. DATA SOURCES: Terms related to predicting time to death after treatment withdrawal were searched in PubMed and Embase from 1993 to November 2021. STUDY SELECTION: Studies endeavoring to predict time to death or describe factors related to time to death were included. Articles focusing on perceptions or practices of treatment withdrawal were excluded. DATA EXTRACTION: Titles, abstracts, and full text of articles were screened to determine eligibility. Data extraction was performed manually. Two-by-two tables were reconstructed with available data from each article to compare performance metrics head to head. DATA SYNTHESIS: Three hundred eighteen citations were identified from the initial search, resulting in 22 studies that were retained for full-text review. Among the pediatric studies, predictive models were developed using multiple logistic regression, Cox proportional hazards, and an advanced machine learning algorithm. In each of the original model derivation studies, the models demonstrated a classification accuracy ranging from 75% to 91% and positive predictive value ranging from 0.76 to 0.93. CONCLUSIONS: There are few tools to predict time to death after withdrawal of life-sustaining treatment in children. They are limited by small numbers and incomplete validation. Future work includes utilization of advanced machine learning models.
Identifier
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<a href="http://doi.org/10.1097/cce.0000000000000764" target="_blank" rel="noreferrer noopener">10.1097/cce.0000000000000764</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Terminal Care
2022
Critical Care Explorations
Decision Support Techniques
Intensive Care Unit
Ledbetter DR
machine learning
November 2022 List
Pediatric
Tissue and Organ Procurement
Winter MC
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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April 2022 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
April 2022 List
URL Address
<a href="http://doi.org/10.1097/cce.0000000000000639" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/cce.0000000000000639</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Palliative Care Utilization Following Out-of-Hospital Cardiac Arrest in Pediatrics
Publisher
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Critical Care Explorations
Date
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2022
Subject
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cardiac arrest; critical care outcomes; do-not-resuscitate; goals-of-care; palliative care; pediatric intensive care unit
Creator
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Gouda SR; Bohr NL; Hoehn KS
Description
An account of the resource
OBJECTIVES: Pediatric out-of-hospital cardiac arrest (OHCA) is associated with significant morbidity and mortality. Pediatric palliative care (PPC) services could provide an integral component of the comprehensive care necessary for these patients and their families. The main objectives of this study are to examine the utilization of PPC following OHCA and compare the differences in characteristics between children who received PPC with those who did not. DESIGN: Retrospective cohort study. SETTING: An urban, tertiary PICU. PATIENTS: Children less than 21 years old admitted from October 2009 to October 2019 with an admitting diagnosis of OHCA and minimum PICU length of stay (LOS) of 48 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of the 283 patient charts reviewed, 118 patient encounters met inclusion criteria. Of those, 34 patients (28.8%) received a PPC consultation during hospitalization. Patients who received PPC had a longer PICU LOS (14.5 vs 4.0 d), a greater number of ventilator days (12.5 vs 4.0 d), and a larger proportion of do-not-resuscitate (DNR) statuses (41% vs 19%). When comparing the disposition of survivors, a greater proportion was discharged to rehab or nursing facilities (47% vs 28%), with no difference in mortality rates (53% vs 50%). In the multivariate logistic regression model, older age, longer LOS, and code status (DNR) were all associated with higher likelihood of PPC utilization. Data were analyzed using descriptive, Mann-Whitney U, and Fisher exact statistics. CONCLUSIONS: Our study demonstrates PPC services following OHCA are underutilized given the high degree of morbidity and mortality. The impact of automatic PPC consultation in all OHCA patients who survive beyond 48 hours should be explored further. Future studies are warranted to understand the benefits and barriers of PPC integration into standard postarrest care for patients and families.
Identifier
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<a href="http://doi.org/10.1097/cce.0000000000000639" target="_blank" rel="noreferrer noopener">10.1097/cce.0000000000000639</a>
2022
April 2022 List
Bohr NL
Cardiac Arrest
Critical Care Explorations
critical care outcomes
do-not-resuscitate
goals-of-care
Gouda SR
Hoehn KS
Palliative Care
Pediatric Intensive Care Unit
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
April 2021 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
April 2021 List
URL Address
<a href="http://doi.org/10.1097/CCE.0000000000000347" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/CCE.0000000000000347</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
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Resources and Costs Associated With Repeated Admissions to PICUs
Publisher
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Critical Care Explorations
Date
A point or period of time associated with an event in the lifecycle of the resource
2021
Subject
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pediatric; intensive care units; healthcare costs; patient readmission
Creator
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Kane JM; Hall M; Cecil C; Montgomery VL; Rakes LC; Rogerson C; Stockwell JA; Slain KN; Goodman DM
Description
An account of the resource
Objective: To determine the costs and hospital resource use from all PICU patients readmitted with a PICU stay within 12 months of hospital index discharge. Design: Cross-sectional, retrospective cohort study using Pediatric Health Information System. Setting: Fifty-two tertiary children’s hospitals. Subjects: Pediatric patients under 18 years old admitted to the PICU from January 1, 2016, to December 31, 2017. Interventions: None. Measurements and Main Results: Patient characteristics and costs of care were compared between those with readmission requiring PICU care and those with only a single PICU admission per annum. In this 2-year cohort, there were 239,157 index PICU patients of which 36,970 (15.5%) were readmitted and required PICU care during the 12 months following index admission. The total hospital cost for all index admissions and readmissions was $17.3 billion, of which 21.5% ($3.71 billion) were incurred during a readmission stay involving care in the PICU; of the 3,459,079 hospital days, 20.3% (702,200) were readmission days including those where PICU care was required. Of the readmitted patients, 11,703 (30.0%) received only PICU care, accounting for $662 million in costs and 110,215 PICU days. Although 43.6% of all costs were associated with patients who required readmission, these patients only accounted for 15.5% of the index patients and 28% of index hospitalization expenditures. More patients in the readmitted group had chronic complex conditions at index discharge compared with those not readmitted (83.9% vs 54.9%; p < 0.001). Compared with those discharged directly to home without home healthcare, patients discharged to a skilled nursing facility had 18% lower odds of readmission (odds ratio 0.82 [95% CI, 0.75–0.89]; p < 0.001) and those discharged home with home healthcare had 43% higher odds of readmission (odds ratio, 1.43 [95% CI, 1.36–1.51]; p < 0.001). Conclusions: Repeated admissions with PICU care resulted in significant direct medical costs and resource use for U.S. children’s hospitals.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1097/CCE.0000000000000347" target="_blank" rel="noreferrer noopener">10.1097/CCE.0000000000000347</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2021
April 2021 List
Cecil C
Critical Care Explorations
Goodman DM
Hall M
healthcare costs
Intensive Care Units
Kane JM
Montgomery VL
patient readmission
Pediatric
Rakes LC
Rogerson C
Slain KN
Stockwell JA