Table 2.
Clinical Characteristics at PICU Admission for Children Whose Families Did and Did Not Discuss Limitation or Withdrawal of Life Support With Clinicians
| Did Not Have Discussions | Had Discussions | ||
|---|---|---|---|
| Clinical Characteristics |
n = 9,830 n (%) |
n = 248 n (%) |
pa |
| Primary diagnosis | < 0.001 | ||
| Respiratory | 3,285 (33.4) | 91 (36.7) | |
| Cancer | 359 (3.7) | 11 (4.4) | |
| Cardiovascular (acquired) | 624 (6.3) | 49 (19.8) | |
| Cardiovascular (congenital) | 1,706 (17.4) | 51 (20.6) | |
| Neurologic | 1,987 (20.2) | 35 (14.1) | |
| Miscellaneousb | 1,869 (19.0) | 11 (4.4) | |
| Primary or secondary diagnosis of trauma | 635 (6.5) | 15 (6.0) | 0.795 |
| Chronic diagnoses at admission | 7,213 (73.4) | 201 (81.0) | 0.01 |
| Known developmental delay | 2,373 (24.1) | 98 (39.5) | < 0.001 |
| Baseline Functional Status Scale | < 0.001 | ||
| Good (6, 7) | 7,099 (72.2) | 134 (54.0) | |
| Mildly abnormal (8, 9) | 996 (10.1) | 28 (11.3) | |
| Moderately abnormal (10–15) | 1,216 (12.4) | 53 (21.4) | |
| Severely abnormal (16–21) | 397 (4.0) | 20 (8.1) | |
| Very severely abnormal (> 21) | 122 (1.2) | 13 (5.2) | |
| Baseline Pediatric Overall Performance Category | < 0.001 | ||
| Good | 3,847 (39.1) | 69 (27.8) | |
| Mild disability | 3,170 (32.2) | 41 (16.5) | |
| Moderate disability | 1,818 (18.5) | 59 (23.8) | |
| Severe disability | 899 (9.1) | 71 (28.6) | |
| Coma/vegetative | 96 (1.0) | 8 (3.2) | |
| Baseline Pediatric Cerebral Performance Category |
< 0.001 | ||
| Normal | 6,827 (69.5) | 132 (53.2) | |
| Mild disability | 1,547 (15.7) | 33 (13.3) | |
| Moderate disability | 732 (7.4) | 27 (10.9) | |
| Severe disability | 631 (6.4) | 48 (19.4) | |
| Coma/vegetative | 93 (0.9) | 8 (3.2) | |
| Worst Glasgow Coma Scale | < 0.001 | ||
| 8–15 | 9,261 (94.2) | 163 (65.7) | |
| 3–7 | 565 (5.7) | 85 (34.3) | |
| Unable to assess | 4 (0) | 0 (0) | |
| Level of consciousness | < 0.001 | ||
| No coma | 8,412 (85.6) | 118 (47.6) | |
| Coma | 344 (3.5) | 70 (28.2) | |
| Unable to assess | 1,071 (10.9) | 60 (24.2) | |
| Missing | 3 (0) | 0 (0) | |
| Pediatric Risk of Mortality score | < 0.001 | ||
| Median (first quartile, third quartile) | 2 (0, 5) | 11 (4, 19.5) | |
| PICU admission status | < 0.001 | ||
| Elective | 3,636 (37.0) | 31 (12.5) | |
| Emergency | 6,194 (63.0) | 217 (87.5) | |
| Type of PICU admitted to | 0.364 | ||
| Medical/surgical | 7,926 (80.6) | 193 (77.8) | |
| Cardiac/cardiovascular | 1,876 (19.1) | 55 (22.2) | |
| Other | 23 (0.2) | 0 (0) | |
| Unknown | 5 (0.1) | 0 (0) | |
| Admitted postoperatively to PICU | 3,759 (38.2) | 38 (15.3) | < 0.001 |
| Any catastrophic event between 24 hr prior to hospital admission and PICU admissionc |
379 (3.9) | 63 (25.4) | < 0.001 |
| Specific types of catastrophic event between 24 hr prior to hospital admission and PICU admissiond |
|||
| Hypoxic ischemic encephalopathy | 4 (0) | 5 (2.0) | |
| Cardiac arrest | 97 (1.0) | 44 (17.7) | |
| Respiratory arrest | 88 (0.9) | 11 (4.4) | |
| Traumatic brain injury | 137 (1.4) | 13 (5.2) | |
| Spinal cord injury | 6 (0.1) | 1 (0.4) | |
| Stroke | 21 (0.2) | 0 (0) | |
| Other catastrophic event | 41 (0.4) | 1 (0.4) | |
| Clinical service with primary responsibility | < 0.001 | ||
| Medical | 7,750 (78.8) | 231 (93.1) | |
| Cardiovascular surgical | 470 (4.8) | 6 (2.4) | |
| Other surgical | 1,610 (16.4) | 11 (4.4) |
p value reflects the Wilcoxon rank sum test for Pediatric Risk of Mortality III, Cochran-Armitage test for baseline Functional Status Scale, baseline Pediatric Overall Performance Category, and baseline Pediatric Cerebral Performance Category and the χ2 or Fisher exact test for all other variables.
Includes diabetic ketoacidosis, musculoskeletal condition, gastrointestinal disorder, hematologic disorder, renal, and miscellaneous.
Number and proportion of children who experienced any catastrophic events between 24 hr prior to hospital admission and PICU admission.
Number and proportion of children who experienced the specific type of catastrophic event; an individual child could experience more than one type of catastrophic event.