Disparities in intensity of treatment at end-of-life among children according to the underlying cause of death

Title

Disparities in intensity of treatment at end-of-life among children according to the underlying cause of death

Creator

Wolff S; Christiansen CF; Johnsen SP; Schroeder S; Darlington AS; Neergaard MA

Identifier

Publisher

Acta Paediatrica

Date

2021

Subject

children; palliative care; end-of-life; place of death; treatment intensity

Description

Aim: To compare indicators of high-intensity treatment at end-of-life (HI-EOL) among children according to causes of death. Method(s): We conducted a nationwide registry study in Denmark among 938 children of 1-17 years of age who died from natural causes from 2006 to 2016. We identified and compared indicators of HI-EOL within the last month of life across diagnoses. Indicators were hospital admissions, days in hospital, intensive care unit admission, mechanical ventilation, and hospital death. Result(s): Proportions of each indicator of HI-EOL ranged from 27% to 75%. The most common indicators were hospital death (75%) and ICU admission (39%). Compared to children with solid tumours, children with non-cancerous conditions had an adjusted odds ratio of 3.5 (95% CI 2.1-5.9) of having >=3 indicators of HI-EOL within the last month of life and children with haematological cancer had an odds ratio of 11.8 (95% CI 6.1-23.0). Conclusion(s): The underlying diagnosis was strongly associated with HI-EOL. Children who died from solid tumours experienced substantially less intensive treatment than both children with haematological cancer and non-cancerous conditions did. Across non-cancerous diagnoses, the intensity of treatment appeared consistent, which may indicate, that the awareness of palliative care is higher among oncologists than within other paediatric fields. Copyright ©2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd

Rights

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Citation List Month

April 2021 List

Collection

Citation

Wolff S; Christiansen CF; Johnsen SP; Schroeder S; Darlington AS; Neergaard MA, “Disparities in intensity of treatment at end-of-life among children according to the underlying cause of death,” Pediatric Palliative Care Library, accessed November 2, 2024, https://pedpalascnetlibrary.omeka.net/items/show/17522.