The aggressive end-of-life care in pediatric cancer patients in taiwan

The aggressive end-of-life care in pediatric cancer patients in taiwan

Wu LM

Pediatric Blood and Cancer

2018

death; major clinical study; retrospective study; intubation; school child; cancer patient; cancer chemotherapy; conference abstract; medical record review; human; child; female; male; controlled study; diagnosis; hospice care; intensive care unit; do not resuscitate order; Taiwan; patent

Background/Objectives: Despite the dramatically improved outcomes for pediatric cancer patients, cancer is the leading cause of death in Taiwan, accounting for 21.8% of death in 2014. The pediatric end-of-life (EOF) care has not been extensively explored in the pediatric cancer patients. The study was to evaluate the trends in pediatric cancer EOF care in a medical center from 2008-2016 in Taiwan. Design/Methods: A retrospective chart review was conducted. All participants were diagnosed with cancer, and died between 2008 and 2016 in the southern medical center in Taiwan. 74 participants were included. Results: The average age at diagnosis, and death were 7.6+/-5.3 year olds, and 11.3+/-6.1 year olds, respectively. These patients in their last month of life spent greater than 14 days (79.1%) in the hospital, completed Do-Not-Resuscitate (DNR) (79.7%), dying in the intensive care unit (70.3%), received related chemotherapy (63.5%), underwent intubation (39.2%), or received cardiopulmonary resuscitation (5.4%). Only 35.1% patents received hospice care or hospice share-care in their last month of life, of these patents 25 % stared such service within the last 3 days. The care of the pediatric cancer EOF did not change over the study period except for significantly increasing DNR permits, and related chemotherapy in the last month of life. Conclusions: Overly aggressive treatment was reported in the last month of pediatric cancer patients in Taiwan. A quality of EOF care in pediatric cancer patients should be developed to meet the individuals and family's needs and preferences.

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