Pediatric Palliative Care: A Five-Year Retrospective Chart Review Study

Title

Pediatric Palliative Care: A Five-Year Retrospective Chart Review Study

Creator

Thrane SE; Maurer SH; Cohen SM; May C; Sereika SM

Publisher

Journal Of Palliative Medicine

Date

2017

Subject

Child; Life Limiting; Life Threatening; Palliative Care; Patient Survival; Pediatric

Description

BACKGROUND: More children are living with serious illness. However, survival and complexity of illnesses have not been described. OBJECTIVE: To describe types of illnesses, timing of referral, and time to death following referral to palliative care; to examine the associations between demographics and clinical characteristics and patient survival; and to examine whether average daily pain decreases after referral. DESIGN: Retrospective chart review of all children ages 2-16 years referred to palliative care at one large children's hospital during the five-year study period from January 1, 2009, through December 31, 2013. MEASUREMENTS: The primary outcome was patient survival and the main independent predictor was type of illness. Kaplan-Meier estimation was used to estimate patient survival time following referral, Cox proportional hazards regression was used to build predictive models based on gender, age, race, religion, and types of illnesses, and paired t-test compared the assessment of pain before and after referral. RESULTS: The cohort consisted of 256 children. Survival experience did not differ significantly based on gender, age, race, or religion (p ≥ 0.05); however, survival did vary based on referring diagnosis (χ2 = 40.3, df = 4, p < 0.001), particularly cancer. Forty-eight children with three days of pain assessments pre- and postreferral had significantly decreased pain postreferral (t(47) = 1.816, p < 0.05 one tailed), supporting our hypothesis. DISCUSSION: Results provide important information on the complexity of disease processes for children referred to palliative care, types of illnesses referred, survival, and pain levels. Results reflect earlier referral to palliative care for most children and highlight the medical complexity especially for children with congenital and genetic diagnoses.

Rights

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).

Citation List Month

August 2017 List

PMID

PMID: 28586256

Citation

Thrane SE; Maurer SH; Cohen SM; May C; Sereika SM, “Pediatric Palliative Care: A Five-Year Retrospective Chart Review Study,” Pediatric Palliative Care Library, accessed July 6, 2022, https://pedpalascnetlibrary.omeka.net/items/show/10981.

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