Table 3.
End-of-Life Care by Pediatric Palliative Care Consultation
| All (N=147)* | Non-PPC (N=110)** | PPC (N=37)*** | P value | |
|---|---|---|---|---|
|
| ||||
| Prognosis discussion | ||||
|
| ||||
| Documented discussion, n (%) | 96 (87%) (N=110) | 62 (83%) (N=75) | 34 (97%) (N=35) | 0.04 |
|
| ||||
| Timing of discussion (median days before death [IQR]) | 4 (1–18) (N=96) | 2 (1–13) (N=75) | 8 (4–26) (N=35) | <0.001 |
|
| ||||
| Resuscitation status discussion | ||||
|
| ||||
| Documented discussion, n (%) | 71 (68%) (N=105) | 41 (58%) (N=71) | 30 (88%) (N=34) | 0.002 |
|
| ||||
| Timing of discussion (median days before death [IQR]) | 3.5 (1–13) (N=70) | 2 (1–5) (N=71) | 7 (3–18) (N=34) | <0.001 |
|
| ||||
| End-of-Life Care Characteristics | ||||
|
| ||||
| Order documenting resuscitation status, n (%) | 56 (80%) (N=70) | 27 (68%) (N=40) | 29 (97%) (N=30) | 0.002 |
|
| ||||
| CPR attempted, n (%) | 15 (14%) (N=104) | 14 (20%) (N=71) | 1 (3%) (N=33) | 0.03 |
|
| ||||
| Intubated in last 24 hours of life, n (%) | 66 (58%) (N=113) | 51 (66%) (N=77) | 15 (42%) (N=36) | 0.02 |
|
| ||||
| Hospital deaths that occurred in ICU | 71 (58%) (N=123) | 53 (80%) (N=66) | 18 (58%) (N=31) | 0.03 |
|
| ||||
| Death at home (versus hospital), n (%) | 71 (73%) (N=97) | 20 (23%) (N=86) | 6 (16%) (N=37) | 0.5 |
|
| ||||
| Location of death, n (%) | 0.06 | |||
| Home | 26 (21%) | 20 (23%) | 6 (16%) | |
| Hospital (non-ICU) | 26 (21%) | 13 (15%) | 13 (35%) | |
| ICU | 71 (58%) (N=123) | 53 (62%) (N=86) | 18 (49%) (N=37) | |
|
| ||||
| Hospice involved, n (%) | 20 (19%) (N=105) | 12 (18%) (N=68) | 8 (22%) (N=37) | 0.6 |
Denominator=147 in this column unless stated otherwise
Denominator=110 in this column unless stated otherwise
Denominator=37 in this column unless stated otherwise
Abbreviations: PPC=pediatric palliative care; IQR =interquartile range; ICU=intensive care unit; CPR=cardiopulmonary resuscitation