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.


METHODS
National cohort of PICU admissions linked to Office of National Statistics death certificate data.


METHODS
31 PICUs in Great Britain.


METHODS
A cohort of 35 383 children admitted to PICUs between 1 November 2002 until 25 January 2007.


METHODS
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.
Fraser
Lorna K
LK
Paediatric Epidemiology Group, Centre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK.
Miller
Michael
M
Draper
Elizabeth S
ES
McKinney
Patricia A
PA
Parslow
Roger C
RC
D000293:Adolescent; D002648:Child; D046688:Child Mortality; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data; D017051:Hospice Care / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D008297:Male; D010166:Palliative Care / Q000706:statistics & numerical data*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology