Place of death and palliative care following discharge from paediatric intensive care units

Objective To determine where children die following discharge from paediatric intensive care units (PICUs) in Great Britain and to investigate if this varies by discharge to palliative care. Design National cohort of PICU admissions linked to Office of National Statistics death certificate data. Setting 31 PICUs in Great Britain. Participants A cohort of 35 383 children admitted to PICUs between 1 November 2002 until 25 January 2007. Main Outcome Measures Place of death by palliative care discharge status. Results 2346 (6.6%) deaths occurred after discharge during the study period, which is more than 10 times the normal child population mortality of 6.0 per 1000. Discharge to palliative care resulted in fewer deaths in hospital (44.1%) (compared to non-palliative care discharges (77.7%)), a greater proportion of deaths were at home (33.3% compared to non-palliative discharges 16.1%) and in a hospice (22.5% compared to non-palliative discharges 5.8%). Conclusions Children referred to palliative care services at discharge from PICU are more likely to die in the community (home or hospice) than children not referred to palliative care.