End of life in patients under the care of paediatric palliative care teams. Multicentre observational study

Cantero, Maŕıa José; Asencio, José Miguel Morales; Marchena, Lucía Navarro; González, Maria del Rosario Velázquez; Echàniz, Jesús Sánchez; Ortega, Laura Rubio; Alba, Ricardo Martino

doi:10.1016/j.anpede.2022.04.008

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…1,6 In Spain, several studies describe the circumstances of death and decision-making in paediatric inpatients, but they are limited to intensive care units (ICUs) or palliative care (PC) services. [7][8][9][10][11] All of them report that most deaths occur in children with complex conditions and after withdrawing or withholding treatment. To our knowledge, there are currently no publications that describe the circumstances of death in paediatric patients overall in the health-care context of our country.…”

Section: What This Paper Addsmentioning

confidence: 99%

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How do hospitalised children die? The context of death and end‐of‐life decision‐making

Serrano-Pejenaute

Carmona-Nunez

Zorrilla-Sarriegui

et al. 2023

J Paediatrics Child Health

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Aim The decrease in childhood mortality, the growing clinical complexity and the greater technification of intensive care units have changed the circumstances of death of paediatric patients. The aim of this study is to describe the context of death and end‐of‐life decision‐making. Methods Single‐centre, retrospective, observational study of deaths in inpatients or home hospitalised children under 18 years old between 2011 and 2021. Demographic data, pathological history and circumstances of death were obtained from the medical record. The whole study period was divided into two halves for the analysis of the temporal trends. Results A total of 358 patients died, 63.2% under the age of 1 year old; 86.9% had underlying life‐limiting illnesses and 73.2% died in the intensive care unit, with no differences between the two time periods. Death at home was significantly higher in the second study period (3.8% vs. 9%). A total of 20.1% died during advanced cardiopulmonary resuscitation. Life‐sustaining treatment was withheld or withdrawn in 53.6%, with no differences between the time courses. Life‐sustaining treatment was withheld mainly in patients with neurological, metabolic and oncological conditions, and less frequently in patients with cardiovascular or respiratory diseases or who were previously healthy. Most patients coded as palliative care (PC) or followed up by PC teams had an advance care plan (ACP) recorded, while in the others it was infrequent. PC coding, following by PC teams and ACP recording increased in the last years of the study. Conclusions Death of children in our setting usually occurs in relation to complex underlying pathology and after the decision of withdrawing or withholding life‐sustaining treatment. In this context, PC and ACP acquire greater importance. In our study, PC involvement resulted in better documentation of ACP and PC coding.

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Section: What This Paper Addsmentioning

confidence: 99%

“…In Spain, several studies describe the circumstances of death and decision‐making in paediatric inpatients, but they are limited to intensive care units (ICUs) or palliative care (PC) services 7–11 . All of them report that most deaths occur in children with complex conditions and after withdrawing or withholding treatment.…”

mentioning

confidence: 99%

How do hospitalised children die? The context of death and end‐of‐life decision‐making

Serrano-Pejenaute

Carmona-Nunez

Zorrilla-Sarriegui

et al. 2023

J Paediatrics Child Health

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“…One US study that reported the characteristics of 515 pediatric palliative care patients found that children took a mean of 9.1 different medications. 26 Studies from Spain 27 and Israel, 28 which focused on children receiving end of life care, reported median numbers of medications of 4 (n = 164) and 4−6 (n = 90) respectively; and a US study about pediatric intensive care patients reported an average daily exposure to 10 different medications (n = 54,549). 24 In the US study, based in a pediatric intensive care unit, 89% of patients were exposed to five or more distinct medications for at least one day, which is the most commonly applied definition of polypharmacy.…”

Section: Introductionmentioning

confidence: 99%

Polypharmacy in Children and Young People With Life-limiting Conditions From 2000 to 2015: A Repeated Cross-sectional Study in England

Fraser¹,

Gibson-Smith²,

Jarvis³

et al. 2022

Journal of Pain and Symptom Management

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Home care needs of paediatric palliative patients perceived by professionals: A grounded theory

Santana-Medina¹,

Rodríguez-Suárez²

2023

Enfermería Clínica (English Edition)

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End of life in patients under the care of paediatric palliative care teams. Multicentre observational study

Cited by 4 publications

References 26 publications

How do hospitalised children die? The context of death and end‐of‐life decision‐making

How do hospitalised children die? The context of death and end‐of‐life decision‐making

Polypharmacy in Children and Young People With Life-limiting Conditions From 2000 to 2015: A Repeated Cross-sectional Study in England

Home care needs of paediatric palliative patients perceived by professionals: A grounded theory

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