Identifying futility in a paediatric critical care setting: a prospective observational study

Title

Identifying futility in a paediatric critical care setting: a prospective observational study

Creator

Goh AY; Mok Q

Publisher

Archives Of Disease In Childhood

Date

2001

Subject

Child; Female; Humans; Male; Intensive Care Units; Medical Futility; Prognosis; Prospective Studies; Euthanasia; Severity of Illness Index; Hospitals; Teaching; quality of life; Preschool; Empirical Approach; Death and Euthanasia; infant; ICU Decision Making; Pediatric/organization & administration; Patient Admission/statistics & numerical data; London; Health Care and Public Health; Critical Illness/classification; Cost Control; Passive/statistics & numerical data

Description

AIMS: To determine the extent of futile care provided to critically ill children admitted to a paediatric intensive care setting. METHODS: Prospective evaluation of consecutive admissions to a 20 bedded multidisciplinary paediatric intensive care unit of a North London teaching hospital over a nine month period. Three previously defined criteria for futility were used: (1) imminent demise futility (those with a mortality risk greater than 90% using the Paediatric Risk of Mortality (PRISM II) score); (2) lethal condition futility (those with conditions incompatible with long term survival); and (3) qualitative futility (those with unacceptable quality of life and high morbidity). RESULTS: A total of 662 children accounting for 3409 patient bed days were studied. Thirty four patients fulfilled at least one of the criteria for futility, and used a total of 104 bed days (3%). Only 33 (0.9%) bed days were used by patients with mortality risk greater than 90%, 60 (1.8%) by patients with poor long term prognosis, and 16 (0.5%) by those with poor quality of life. Nineteen of 34 patients died; withdrawal of treatment was the mode of death in 15 (79%). CONCLUSIONS: Cost containment initiatives focusing on futility in the paediatric intensive care unit setting are unlikely to be successful as only relatively small amounts of resources were used in providing futile care. Paediatricians are recognising futility early and may have taken ethically appropriate measures to limit care that is futile.
2001

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).

Type

Journal Article

Citation List Month

Backlog

Citation

Goh AY; Mok Q, “Identifying futility in a paediatric critical care setting: a prospective observational study,” Pediatric Palliative Care Library, accessed March 29, 2024, https://pedpalascnetlibrary.omeka.net/items/show/11902.