Pediatric Palliative Care: A Five-Year Retrospective Chart Review Study
More children are living with serious illness. However, survival and complexity of illnesses have not been described. To describe types of illnesses, timing of referral, and time to death following referral to palliative care; to examine the associations between demographics and clinical characteris...
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| Veröffentlicht in: | Journal of palliative medicine 2017-10, Vol.20 (10), p.1104-1111 |
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| container_title | Journal of palliative medicine |
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| creator | Thrane, Susan E Maurer, Scott H Cohen, Susan M May, Carol Sereika, Susan M |
| description | More children are living with serious illness. However, survival and complexity of illnesses have not been described.
To describe types of illnesses, timing of referral, and time to death following referral to palliative care; to examine the associations between demographics and clinical characteristics and patient survival; and to examine whether average daily pain decreases after referral.
Retrospective chart review of all children ages 2-16 years referred to palliative care at one large children's hospital during the five-year study period from January 1, 2009, through December 31, 2013.
The primary outcome was patient survival and the main independent predictor was type of illness. Kaplan-Meier estimation was used to estimate patient survival time following referral, Cox proportional hazards regression was used to build predictive models based on gender, age, race, religion, and types of illnesses, and paired t-test compared the assessment of pain before and after referral.
The cohort consisted of 256 children. Survival experience did not differ significantly based on gender, age, race, or religion (p ≥ 0.05); however, survival did vary based on referring diagnosis (χ
= 40.3, df = 4, p |
| doi_str_mv | 10.1089/jpm.2017.0038 |
| format | Article |
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To describe types of illnesses, timing of referral, and time to death following referral to palliative care; to examine the associations between demographics and clinical characteristics and patient survival; and to examine whether average daily pain decreases after referral.
Retrospective chart review of all children ages 2-16 years referred to palliative care at one large children's hospital during the five-year study period from January 1, 2009, through December 31, 2013.
The primary outcome was patient survival and the main independent predictor was type of illness. Kaplan-Meier estimation was used to estimate patient survival time following referral, Cox proportional hazards regression was used to build predictive models based on gender, age, race, religion, and types of illnesses, and paired t-test compared the assessment of pain before and after referral.
The cohort consisted of 256 children. Survival experience did not differ significantly based on gender, age, race, or religion (p ≥ 0.05); however, survival did vary based on referring diagnosis (χ
= 40.3, df = 4, p < 0.001), particularly cancer. Forty-eight children with three days of pain assessments pre- and postreferral had significantly decreased pain postreferral (t(47) = 1.816, p < 0.05 one tailed), supporting our hypothesis.
Results provide important information on the complexity of disease processes for children referred to palliative care, types of illnesses referred, survival, and pain levels. Results reflect earlier referral to palliative care for most children and highlight the medical complexity especially for children with congenital and genetic diagnoses.</description><identifier>ISSN: 1096-6218</identifier><identifier>EISSN: 1557-7740</identifier><identifier>DOI: 10.1089/jpm.2017.0038</identifier><identifier>PMID: 28586256</identifier><language>eng</language><publisher>United States: Mary Ann Liebert, Inc</publisher><subject>Adolescent ; Child ; Child, Preschool ; Chronic Disease - mortality ; Chronic Disease - therapy ; Female ; Hospitals, Pediatric - statistics & numerical data ; Humans ; Male ; Original ; Palliative Care - statistics & numerical data ; Retrospective Studies ; Survival Analysis ; Time Factors</subject><ispartof>Journal of palliative medicine, 2017-10, Vol.20 (10), p.1104-1111</ispartof><rights>Copyright 2017, Mary Ann Liebert, Inc. 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c387t-cc8aefd8e64b9b61f0bae6a508fe4084994579d7bbc6f285dc26716c4ef1d5963</citedby><cites>FETCH-LOGICAL-c387t-cc8aefd8e64b9b61f0bae6a508fe4084994579d7bbc6f285dc26716c4ef1d5963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28586256$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Thrane, Susan E</creatorcontrib><creatorcontrib>Maurer, Scott H</creatorcontrib><creatorcontrib>Cohen, Susan M</creatorcontrib><creatorcontrib>May, Carol</creatorcontrib><creatorcontrib>Sereika, Susan M</creatorcontrib><title>Pediatric Palliative Care: A Five-Year Retrospective Chart Review Study</title><title>Journal of palliative medicine</title><addtitle>J Palliat Med</addtitle><description>More children are living with serious illness. However, survival and complexity of illnesses have not been described.
To describe types of illnesses, timing of referral, and time to death following referral to palliative care; to examine the associations between demographics and clinical characteristics and patient survival; and to examine whether average daily pain decreases after referral.
Retrospective chart review of all children ages 2-16 years referred to palliative care at one large children's hospital during the five-year study period from January 1, 2009, through December 31, 2013.
The primary outcome was patient survival and the main independent predictor was type of illness. Kaplan-Meier estimation was used to estimate patient survival time following referral, Cox proportional hazards regression was used to build predictive models based on gender, age, race, religion, and types of illnesses, and paired t-test compared the assessment of pain before and after referral.
The cohort consisted of 256 children. Survival experience did not differ significantly based on gender, age, race, or religion (p ≥ 0.05); however, survival did vary based on referring diagnosis (χ
= 40.3, df = 4, p < 0.001), particularly cancer. Forty-eight children with three days of pain assessments pre- and postreferral had significantly decreased pain postreferral (t(47) = 1.816, p < 0.05 one tailed), supporting our hypothesis.
Results provide important information on the complexity of disease processes for children referred to palliative care, types of illnesses referred, survival, and pain levels. Results reflect earlier referral to palliative care for most children and highlight the medical complexity especially for children with congenital and genetic diagnoses.</description><subject>Adolescent</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Chronic Disease - mortality</subject><subject>Chronic Disease - therapy</subject><subject>Female</subject><subject>Hospitals, Pediatric - statistics & numerical data</subject><subject>Humans</subject><subject>Male</subject><subject>Original</subject><subject>Palliative Care - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>Survival Analysis</subject><subject>Time Factors</subject><issn>1096-6218</issn><issn>1557-7740</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkDlPwzAUxy0EoqUwsqKMLCl2El8MSFVFCxISFcfAZDnOC3WVNMFJivrtcdRSwfSu_7t-CF0SPCZYyJtVXY4jTPgY41gcoSGhlIecJ_jY-1iykEVEDNBZ06ww9g2YnqJBJKhgEWVDNF9AZnXrrAkWuii8azcQTLWD22ASzHwQfoB2wQu0rmpqMLv6UrvW5zYWvoPXtsu25-gk10UDF3s7Qu-z-7fpQ_j0PH-cTp5CEwvehsYIDXkmgCWpTBnJcaqBaYpFDgkWiZQJ5TLjaWpY7q_MTMQ4YSaBnGRUsniE7nZz6y4tITOwbp0uVO1sqd1WVdqq_5W1XarPaqMoSzj1jEboej_AVV8dNK0qbWOgKPQaqq5RRGLuZZL2u8Kd1PjXGwf5YQ3BqoevPHzVw1c9fK-_-nvbQf1LO_4BthWBLw</recordid><startdate>201710</startdate><enddate>201710</enddate><creator>Thrane, Susan E</creator><creator>Maurer, Scott H</creator><creator>Cohen, Susan M</creator><creator>May, Carol</creator><creator>Sereika, Susan M</creator><general>Mary Ann Liebert, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201710</creationdate><title>Pediatric Palliative Care: A Five-Year Retrospective Chart Review Study</title><author>Thrane, Susan E ; Maurer, Scott H ; Cohen, Susan M ; May, Carol ; Sereika, Susan M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c387t-cc8aefd8e64b9b61f0bae6a508fe4084994579d7bbc6f285dc26716c4ef1d5963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adolescent</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Chronic Disease - mortality</topic><topic>Chronic Disease - therapy</topic><topic>Female</topic><topic>Hospitals, Pediatric - statistics & numerical data</topic><topic>Humans</topic><topic>Male</topic><topic>Original</topic><topic>Palliative Care - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>Survival Analysis</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Thrane, Susan E</creatorcontrib><creatorcontrib>Maurer, Scott H</creatorcontrib><creatorcontrib>Cohen, Susan M</creatorcontrib><creatorcontrib>May, Carol</creatorcontrib><creatorcontrib>Sereika, Susan M</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of palliative medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Thrane, Susan E</au><au>Maurer, Scott H</au><au>Cohen, Susan M</au><au>May, Carol</au><au>Sereika, Susan M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pediatric Palliative Care: A Five-Year Retrospective Chart Review Study</atitle><jtitle>Journal of palliative medicine</jtitle><addtitle>J Palliat Med</addtitle><date>2017-10</date><risdate>2017</risdate><volume>20</volume><issue>10</issue><spage>1104</spage><epage>1111</epage><pages>1104-1111</pages><issn>1096-6218</issn><eissn>1557-7740</eissn><abstract>More children are living with serious illness. However, survival and complexity of illnesses have not been described.
To describe types of illnesses, timing of referral, and time to death following referral to palliative care; to examine the associations between demographics and clinical characteristics and patient survival; and to examine whether average daily pain decreases after referral.
Retrospective chart review of all children ages 2-16 years referred to palliative care at one large children's hospital during the five-year study period from January 1, 2009, through December 31, 2013.
The primary outcome was patient survival and the main independent predictor was type of illness. Kaplan-Meier estimation was used to estimate patient survival time following referral, Cox proportional hazards regression was used to build predictive models based on gender, age, race, religion, and types of illnesses, and paired t-test compared the assessment of pain before and after referral.
The cohort consisted of 256 children. Survival experience did not differ significantly based on gender, age, race, or religion (p ≥ 0.05); however, survival did vary based on referring diagnosis (χ
= 40.3, df = 4, p < 0.001), particularly cancer. Forty-eight children with three days of pain assessments pre- and postreferral had significantly decreased pain postreferral (t(47) = 1.816, p < 0.05 one tailed), supporting our hypothesis.
Results provide important information on the complexity of disease processes for children referred to palliative care, types of illnesses referred, survival, and pain levels. Results reflect earlier referral to palliative care for most children and highlight the medical complexity especially for children with congenital and genetic diagnoses.</abstract><cop>United States</cop><pub>Mary Ann Liebert, Inc</pub><pmid>28586256</pmid><doi>10.1089/jpm.2017.0038</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1096-6218 |
| ispartof | Journal of palliative medicine, 2017-10, Vol.20 (10), p.1104-1111 |
| issn | 1096-6218 1557-7740 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5647500 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Adolescent Child Child, Preschool Chronic Disease - mortality Chronic Disease - therapy Female Hospitals, Pediatric - statistics & numerical data Humans Male Original Palliative Care - statistics & numerical data Retrospective Studies Survival Analysis Time Factors |
| title | Pediatric Palliative Care: A Five-Year Retrospective Chart Review Study |
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