title: Place of death of pediatric cancer patients in a single institute during 7 years.
abstract: Place of death is an important issue at the end-of-life.  It is poorly understood in pediatric cancer patients in Japan. This study aimed  to clarify place of death of children with cancer as well as variables associated  with place of death.  Study population was pediatric cancer patients who died in the Department of  Pediatrics at Kobe University Hospital during the last 7 years. The medical  records were retrospectively reviewed regardless of cause of death to derive  data relating to patients' characteristics and disease.  18 patients were included. Median age at death was 12.2 years old. 6 patients  including 5 children in complete remission had hematological disease and 12  patients suffered from solid tumors.  4 patients (22.2%) died at home, whereas 14 patients (77.8%) died in the hospital  including 6 ICU deaths. No one died in hospices. Preference of patients was  unavailable due to the lack of inquiry. Factors influencing place of death  (home, ICU, non-ICU) were disease (hematological disease vs. solid tumor,  p=0.010, brain tumor vs. non-brain tumor, p=0.023), disease status (complete  remission vs. non-complete remission, p=0.0014) and preference of families  (p=0.029). Among 6 families who expressed preference, no disparity was  observed between actual and preferred place of death.  This is the first English publication of place of death of pediatric  cancer patients in Japan. The low percentage of home death, factors  influencing place of death and the lack of disparity between actual and  preferred place of death were indicated. Further studies are required to  better understand place of death.
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan. yanai@med.kobe-u.ac.jp
authors.forename: Tomoko
authors.initials: T
authors.lastname: Yanai
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hirase
authors.forename: Natsuki
authors.initials: N
authors.lastname: Matsunoshita
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ninchoji
authors.forename: Ikuko
authors.initials: I
authors.lastname: Kubokawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Mori
authors.forename: Akira
authors.initials: A
authors.lastname: Hayakawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Takeshima
authors.forename: Kazumoto
authors.initials: K
authors.lastname: Iijima
authors.forename: Masafumi
authors.initials: M
authors.lastname: Matsuo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003643:Death; D005260:Female; D006699:Home Care Services; D006801:Humans; D007223:Infant; D007564:Japan; D008297:Male; D008499:Medical Records; D009369:Neoplasms / Q000401:mortality*; D057240:Patient Preference; D012189:Retrospective Studies; D013727:Terminal Care; D055815:Young Adult