title: Pediatric hospital dying trajectories: what we learned and can share.
abstract: Diverse settings, diagnoses, and time constraints challenge a small hospital's ability to provide comprehensive care to all dying children and their families. Children who died at a regional hospital in southeast Georgia were studied to document the circumstances under which they died and the palliative and end-of-life care provided. The most common causes of death were injury and circulatory events. At the time of death, 56% of the children studied were in the care of the Emergency Department. Seventy-two percent were previously healthy children; 78% were hospitalized for less than 24 hours prior to death. Based on previous medical history and length of final hospitalization, four hospital dying trajectories were defined. Hospital dying trajectories provide a basis for planning comprehensive hospital pediatric palliative and end-of-life care program by identifying the settings, time limitations, and key personnel.
authors.affiliation: George and Marie Backus Children's Hospital, Memorial Health University Medical Center Inc, Savannah, GA, USA.
authors.forename: Trib S
authors.initials: TS
authors.lastname: Vats
authors.forename: Paula D
authors.initials: PD
authors.lastname: Reynolds
mesh_terms: D000293:Adolescent; D000328:Adult; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D005845:Georgia / Q000453:epidemiology; D017052:Hospital Mortality; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D020380:Needs Assessment; D010166:Palliative Care; D010346:Patient Care Management / Q000458:organization & administration*; D012189:Retrospective Studies; D013727:Terminal Care / Q000379:methods / Q000458:organization & administration