title: Trends in the aggressiveness of end-of-life care for Korean pediatric cancer patients who died in 2007-2010.
abstract: BACKGROUND
  In light of the Korean Supreme Court's 2009 ruling favoring a patient's right to die with dignity, we evaluated trends in aggressive care in a cohort of pediatric cancer patients. Methods We conducted a population-based retrospective study that used administrative data for patients who died in 2007-2010 among the 5,203 pediatric cancer patients registered at the Korean Cancer Central Registry (KCCR) during 2007-2009.
  
  
  RESULTS
  In the time period covered, 696 patients died. The proportion who had received chemotherapy in the last 30 days of life decreased from 58.1% to 28.9% (P<0.001), those who received new chemotherapy in the same time period decreased from 55.2% to 15.1% (P<0.001), and those who received treatment in the last 2 weeks of life decreased from 51.4% to 21.7% (P<0.001). In the last 30 days of life, the proportion of patients whose hospital admission period was over 14 days increased from 70.5% to 82.5% (P = 0.03), the proportion who received cardiopulmonary resuscitation decreased from 28.6% to 9.6% (P<0.001), and we found no statistically significant trends in the proportion of emergency department visits, intensive care unit admissions, or mechanical ventilation.
  
  
  CONCLUSIONS
  In this study, in contrast with earlier ones, the aggressiveness of end-of-life care of Korean pediatric cancer patients decreased dramatically.
authors.affiliation: Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: June Dong
authors.initials: JD
authors.lastname: Park
authors.affiliation: Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea; Cancer Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hyoung Jin
authors.initials: HJ
authors.lastname: Kang
authors.affiliation: Hospital and Research Institute, National Cancer Center, Goyang, Korea.
authors.forename: Young Ae
authors.initials: YA
authors.lastname: Kim
authors.affiliation: Hospital and Research Institute, National Cancer Center, Goyang, Korea.
authors.forename: MinKyoung
authors.initials: M
authors.lastname: Jo
authors.affiliation: Hospital and Research Institute, National Cancer Center, Goyang, Korea.
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea; Cancer Institute, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hee Young
authors.initials: HY
authors.lastname: Shin
authors.affiliation: Cancer Institute, Seoul National University College of Medicine, Seoul, Korea; Departmentof Biomedical Science, Seoul National University Hospital and College of Medicine, Seoul, Korea.
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Yun
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015278:Intensive Care Units, Pediatric / Q000331:legislation & jurisprudence / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends*; D008297:Male; D009369:Neoplasms / Q000401:mortality* / Q000628:therapy*; D011787:Quality of Health Care / Q000331:legislation & jurisprudence / Q000592:standards / Q000639:trends*; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012297:Right to Die; D013727:Terminal Care / Q000331:legislation & jurisprudence / Q000592:standards / Q000706:statistics & numerical data / Q000639:trends*