Table 8.
Chi-Square Comparisons of Infants Referred and Not Referred to Palliative Care
| n | Referred, n (%) | Not referred, n (%) | X2 | df | p | |
|---|---|---|---|---|---|---|
| Infants older than six days | ||||||
| AND order | 323 | 103 (31.9) | 79 (24.5) | 40.9 | 1 | <0.001 |
| Physician notea | 322 | 118 (36.6) | 159 (49.4) | 2.1 | 1 | 0.15 |
| Code activated at time of death | 317 | 12 (3.8) | 41 (12.9) | 9.2 | 1 | 0.002 |
| Life-sustaining therapy withheld | 317 | 112 (35.3) | 150 (47.3) | 1.3 | 1 | 0.26 |
| Respiratory death diagnosis | 320 | 37 (11.6) | 26 (8.1) | 10.3 | 1 | 0.001 |
| Cardiac death diagnosis | 320 | 27 (8.4) | 41 (12.8) | 0.1 | 1 | 0.82 |
| Congenital and/or genetic death diagnosis | 320 | 24 (7.5) | 9 (2.8) | 15.4 | 1 | <0.001 |
| Premature death diagnosis*,b | 320 | 0 (0) | 3 (0.9) | — | — | 0.27 |
| Sepsis death diagnosis | 320 | 5 (1.6) | 28 (8.8) | 10.1 | 1 | 0.001 |
| NEC death diagnosis | 320 | 6 (1.9) | 37 (11.6) | 15.0 | 1 | <0.001 |
| Neurologic death diagnosis | 325 | 17 (5.2) | 18 (5.5) | 0.9 | 1 | 0.35 |
| Organ failure death diagnosis | 320 | 6 (1.9) | 9 (2.8) | 0.006 | 1 | 0.94 |
| Infants younger than seven days | ||||||
| AND order | 146 | 24 (16.4) | 38 (26.0) | 17.8 | 1 | <0.001 |
| Physician note* | 148 | 31 (20.9) | 95 (64.2) | — | — | 0.046 |
| Code activated at time of death | 144 | 3 (2.1) | 30 (20.8) | 4.3 | 1 | 0.04 |
| Life-sustaining therapy withheld | 144 | 26 (18.1) | 82 (56.9) | 1.6 | 1 | 0.20 |
| Respiratory death diagnosis | 148 | 9 (6.1) | 29 (19.6) | 0.1 | 1 | 0.72 |
| Cardiac death diagnosis | 148 | 3 (2.0) | 22 (14.9) | 1.6 | 1 | 0.20 |
| Neurologic death diagnosis* | 148 | 4 (2.7) | 19 (12.8) | — | — | 0.78 |
| Premature death diagnosis* | 148 | 0 (0) | 2 (1.4) | — | — | 0.61 |
| Congenital and/or genetic death diagnoses* | 148 | 8 (5.4) | 12 (8.1) | — | — | 0.04 |
| Sepsis death diagnosis* | 148 | 0 (0) | 9 (6.1) | — | — | 0.21 |
| NEC death diagnosis* | 148 | 0 (0) | 5 (3.4) | — | — | 0.59 |
| Organ failure death diagnosis* | 148 | 6 (4.1) | 7 (4.7) | — | — | 0.04 |
Note: all chi square p-values are asymptotic. Bolded p-values are significant.
*
Fisher's exact test: exact two-tailed probability.
a
Physician note = a physician documented that further treatment may not have benefit. These documentations appeared in note templates that are specifically designed to accompany Do Not Resuscitate and AND orders.
b
Premature death diagnosis refers to infants who were extremely premature, and no other cause of death was listed on the death certificate.