Palliative care referral patterns for children with cancer: A three-year retrospective study

Palliative care referral patterns for children with cancer: A three-year retrospective study

Kim MS; Kim CH; Moon YJ; Song IG; Shin HY

Pediatric Blood and Cancer

2018

quality of life; infant; hospice; oncology; Korea; terminal care; lymphoma; palliative therapy; major clinical study; central nervous system; cancer patient; hospital patient; school child; pediatric ward; solid malignant neoplasm; time of death; patient referral; conference abstract; statistical analysis; human; child; female; male; diagnosis; resuscitation; emergency ward; intensive care unit; retrospective study; leukemia; outpatient department

Background/Objectives: Although Pediatric palliative care (PPC) has developed worldwide with the increasing number of children with serious illness, the concept of Pediatric palliative care is still unfamiliar in Asia. We report on Pediatric cancer patient referral patterns to a new PPC team at a university-affiliated children's hospital in Korea. Design/Methods: We examined our PPC database and performed descriptive statistical analysis of patient referral from hemato-oncology Department. Results: From April 2015 to March 2018, 142 patients were referred to PPC team from hemato-oncology Department. Ten patients (7.0%) were not seen in consultation by our team because of refusal of palliative care, referral to another hospital, or immediate death before consultation. Of 132 patients, eight patients were under 1 year-old, 53 were ages 1 to 9 years, 54 were ages 10-18 years, and 17 were older than 18. Most of our patients (72.0%) lived in distant region from our hospital and 76 patients (58%) were male. Diagnoses included solid tumor (35.6%), primary CNS (32.6%) and leukemia/lymphoma (29.5%). Significant number of patients were referred while in the Pediatric ward (76.5%), and 18.2% and 5.3% were from outpatient clinic and intensive care unit, respectively. Lastly, 84 patients (63.6%) died during the observation period, and of those, 61 (72.6%) died in an inpatient setting, 13 (15.5%) died at home, 9 (10.7%) died at hospice facilities, and one (1.2%) died in the emergency Department. At the time of death, most patients (95.2%) did not receive cardiopulmonary resuscitation (CPR) according to the end-of-life care plan, but 3 patients received CPR. The median age at death was 11.2 years. Conclusions: We report the palliative care referral patterns of Pediatric cancer patients in Korean children's hospital. To improve the quality of life of children with cancer, their palliative care needs should be identified and appropriate services be provided.

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