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Relationship Between Palliative Care Consults and Outcomes of Pediatric Surgical Patients During Terminal Admissions.
- Source :
-
Journal of Palliative Medicine . Aug2023, Vol. 26 Issue 8, p1074-1080. 7p. - Publication Year :
- 2023
-
Abstract
- Background: Pediatric patients often undergo surgery during terminal admissions. However, the involvement and timing of palliative care consults in caring for these patients has not been readily described. Objective: To describe the presence and timing of palliative care consults for pediatric patients who undergo surgical procedures during terminal admissions. Design: Retrospective cohort study using data from the electronic health record. Setting and Participants: Pediatric patients who underwent at least one surgical procedure during a terminal admission at an urban, quaternary hospital in the United States from January 1, 2016 to December 31, 2021. Main Outcomes and Measures: Patients' medical, surgical, and admission-level characteristics were abstracted. Associations were evaluated between these characteristics and the occurrence and timing of a palliative care consult relative to surgery and death. Results: Of 134 patients, 84% received a palliative care consult during their terminal admission. Approximately 36% of consults occurred before surgery, and 12% were within one day of death. Children without a palliative care consult were more likely than children with a consult to die during surgery (19.1% vs. 2.7%, p = 0.02), have surgery within 24 hours of death (52.4% vs. 15.9%, p < 0.001), and undergo a full resuscitation attempt (47.6% vs. 12.4%, p = 0.002). Receipt of a palliative care consultation did not differ by patient sex, reported race and ethnicity, language, insurance, or income level. Conclusions and Relevance: Palliative care consults support high-quality end-of-life care for children and impact perioperative outcomes, including intensity of surgical care and resuscitation in the final hours of life. [ABSTRACT FROM AUTHOR]
- Subjects :
- *TERMINAL care
*CONFIDENCE intervals
*SURGERY
*PATIENTS
*RETROSPECTIVE studies
*FISHER exact test
*MANN Whitney U Test
*TREATMENT effectiveness
*PALLIATIVE medicine
*MEDICAL referrals
*DESCRIPTIVE statistics
*CHI-squared test
*ELECTRONIC health records
*RESUSCITATION
*ODDS ratio
*PALLIATIVE treatment
*PEDIATRIC surgery
*LONGITUDINAL method
*CHILDREN
Subjects
Details
- Language :
- English
- ISSN :
- 10966218
- Volume :
- 26
- Issue :
- 8
- Database :
- Academic Search Index
- Journal :
- Journal of Palliative Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 169951186
- Full Text :
- https://doi.org/10.1089/jpm.2022.0610