Table 4.
Clinical Characteristics at Hospital Discharge 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 (%) | n (%) | pa |
| All patients | n = 9,830 | n = 248 | |
| Death at hospital discharge | 102 (1.0) | 173 (69.8) | < 0.001 |
| Discharge Pediatric Cerebral Performance Category | < 0.001 | ||
| Normal | 6,492 (66.0) | 9 (3.6) | |
| Mild disability | 1,724 (17.5) | 10 (4.0) | |
| Moderate disability | 750 (7.6) | 6 (2.4) | |
| Severe disability | 669 (6.8) | 35 (14.1) | |
| Coma/vegetative | 93 (0.9) | 15 (6.0) | |
| Death | 102 (1.0) | 173 (69.8) | |
| Discharge Pediatric Overall Performance Category | < 0.001 | ||
| Good | 3,025 (30.8) | 1 (0.4) | |
| Mild disability | 3,903 (39.7) | 1 (0.4) | |
| Moderate disability | 1,764 (17.9) | 12 (4.8) | |
| Severe disability | 939 (9.6) | 46 (18.5) | |
| Coma/vegetative | 97 (1.0) | 15 (6.0) | |
| Death | 102 (1.0) | 173 (69.8) | |
| Hospital survivors | n = 9,728 | n = 75 | |
| Hospital discharge Functional Status Score total | < 0.001 | ||
| Good (6, 7) | 6,333 (65.1) | 1 (1.3) | |
| Mildly abnormal (8, 9) | 1,446 (14.9) | 5 (6.7) | |
| Moderately abnormal (10–15) | 1,359 (14.0) | 29 (38.7) | |
| Severely abnormal (16–21) | 444 (4.6) | 20 (26.7) | |
| Very severely abnormal (> 21) | 146 (1.5) | 20 (26.7) | |
| Hospital discharge location | < 0.001 | ||
| Home or foster care | 9,074 (93.3) | 53 (70.7) | |
| Chronic care or skilled nursing facility | 152 (1.6) | 13 (17.3) | |
| Another acute care hospital | 168 (1.7) | 6 (8.0) | |
| Acute inpatient rehabilitation unit | 265 (2.7) | 2 (2.7) | |
| Other | 69 (0.7) | 1 (1.3) | |
| Discharged with hospice services | 18 (0.2) | 28 (37.3) | < 0.001 |
| Hospital deaths | n = 102 | n = 173 | |
| Location at time of death (n = 275) | < 0.001 | ||
| PICU | 86 (84.3) | 166 (96.0) | |
| Hospital general care | 6 (5.9) | 6 (3.5) | |
| Other | 10 (9.8) | 1 (0.6) | |
| Mode of death | < 0.001 | ||
| Failed resuscitation | 43 (42.2) | 10 (5.8) | |
| Withdrawal of support | 20 (19.6) | 121 (69.9) | |
| Limitation of support | 18 (17.6) | 28 (16.2) | |
| Brain death | 21 (20.6) | 14 (8.1) | |
| Hospital length of stay, d | < 0.01 | ||
| Median (first quartile, third quartile) | 13.70 (3.70, 51.41) | 7.84 (2.22, 19.47) |
a
p value reflects the Cochran-Armitage test for hospital discharge Pediatric Cerebral Performance Category, Pediatric Overall Performance Category, and Functional Status Score total scores, Wilcoxon rank sum test for hospital length of stay, and χ2 or Fisher exact test for all other variables.