Variables influencing end-of-life care in children and adolescents with cancer
Title
Variables influencing end-of-life care in children and adolescents with cancer
Creator
Klopfenstein KJ; Hutchison C; Clark C; Young D; Ruymann FB
Identifier
Publisher
Journal Of Pediatric Hematology/oncology
Date
2001
Subject
Child; Female; Humans; Male; Adult; Withholding Treatment; Resuscitation Orders; adolescent; Preschool; Empirical Approach; Death and Euthanasia; decision making; infant; cause of death; Neoplasms/complications/therapy; location of death; hospice care; home care services; Terminal Care/trends
Description
BACKGROUND: The purpose of this study was to describe the variables influencing end-of-life care in children and adolescents dying of cancer. MATERIALS AND METHODS: Records of 146 children with cancer who died at Children's Hospital were reviewed for demographics, diagnosis, location of death, withdrawal of life support, use of "do not resuscitate" (DNR) orders, and the length of time that those orders were in effect. RESULTS: Ninety-five patients were evaluated. Fifty-nine died of progressive disease and 36 deaths were therapy-related. Sixty-four percent of disease-related deaths occurred at home with support from home care or hospice. Only 10% of all patients died while receiving maximal aggressive support in the intensive care unit. Age, diagnosis (solid tumor vs. leukemia), cause of death, length of last hospital admission, and the duration of DNR orders had a significant correlation with the place of death and referral to and use of hospice. Thirty-five percent of all patients had hospice support. CONCLUSIONS: Most children who die of cancer die because of progressive disease at home with hospice support. Do not resuscitate orders were written for most patients who died. End-of-life decisions are influenced by patient diagnosis, cause of death, and age.
Rights
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Type
Journal Article
Citation List Month
Backlog
URL Address
Citation
Klopfenstein KJ; Hutchison C; Clark C; Young D; Ruymann FB, “Variables influencing end-of-life care in children and adolescents with cancer,” Pediatric Palliative Care Library, accessed October 3, 2023, https://pedpalascnetlibrary.omeka.net/items/show/11961.