Cancer-related deaths in children and adolescents.
BACKGROUND
To add to the data regarding the quality of care given to dying children and their families.


OBJECTIVE
To develop baseline of end-of-life care at a single pediatric facility to evaluate institution-wide palliative care initiative.


METHODS
Retrospective chart review of all known deaths during an 18-month time period.


METHODS
One hundred forty-five charts of patients from a single pediatric cancer facility who died during designated time period.


METHODS
Variables included: cause and place of death; CPR/DNR status prior to death; length of end of life care prior to death; sibling counseling and bereavement counseling offered to family after death; and wishes or preferences of patient/family regarding the death experience.


RESULTS
Results included: solid tumor patients more likely to die of progressive disease than leukemia or bone marrow transplant patients; bone marrow transplant patients 2-3 times more likely to die of cardiopulmonary or cardiovascular complications; solid tumor patients were more likely to die at home than leukemia patients; solid tumor/brain tumor patients had a median time in end of life or palliative care of 29 days compared to leukemia patients' median of 11 days; 48% of DNRs completed 11 days prior to death.


CONCLUSIONS
Relationship exists between diagnosis, cause and place of death in this population; findings replicate findings of 4 similar studies; accurate and consistent quality standards of care need to be established for this population as well as methods of documentation before reviewing/accrediting agencies impose standards that are not evidence based.
Bradshaw
Glenna
G
Baptist Memorial Hospital-East, Memphis, Tennessee, USA.
Hinds
Pamela S
PS
Lensing
Shelly
S
Gattuso
Jami S
JS
Razzouk
Bassem I
BI
D000293:Adolescent; D000328:Adult; D002648:Child; D046688:Child Mortality; D002675:Child, Preschool; D003657:Decision Making; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008499:Medical Records; D009369:Neoplasms / Q000175:diagnosis / Q000401:mortality*; D011787:Quality of Health Care / Q000592:standards; D016414:Resuscitation Orders / Q000523:psychology*; D012189:Retrospective Studies; D013727:Terminal Care / Q000592:standards*