Table 3.
End-of-life characteristics of 43 pediatric patients undergoing compassionate de-escalation of life-sustaining treatments.
| End-of-life characteristic | Frequency (%) a |
|---|---|
| Cancer-directed treatment during the last month of life | |
| Yes | 25 (58.1) |
| No | 18 (41.9) |
| Cancer-directed treatment during the last week of life | |
| Yes | 20 (46.5) |
| No | 23 (53.5) |
| No. Palliative Care visits | |
| Mean (SD) | 14.2 (14.7) |
| Median [Min, Max] | 9 [0, 61] |
| No. patients who met Palliative Care on DOD | 8 (18.6) |
| No. Pain Service visits | |
| Mean (SD) | 6.98 (25.2) |
| Median [Min, Max] | 0 [0, 118] |
| No. patients who did not interact with the Pain Service | 36 (83.7) |
| Goal of Care | |
| Cure | 24 (55.8) |
| Comfort | 10 (23.2) |
| Life prolongation | 4 (9.3) |
| Poor prognosis b | 2 (4.7) |
| Life prolongation and comfort | 1 (2.3) |
| Not documented | 2 (4.7) |
| Enrolled in Hospice | |
| Yes | 5 (11.6) |
| No | 38 (88.3) |
| POST in place | |
| Yes | 38 (88.3) |
| No | 5 (11.6) |
| CPR administered on DOD | |
| Yes | 1 (2.3) |
| No | 42 (97.6) |
| Time between POST and DOD (days) | |
| Mean (SD) | 13.9 (61) |
| Median [Min, Max] | 1 [0, 373] |
| Time between intubation and DOD (days) | |
| Mean (SD) | 1 (2.78) |
| Median [Min, Max] | 0 [0, 14] |
| Examination for brain death c | |
| Yes | 5 (11.6) |
| No | 38 (88.4) |
a
Frequency indicates the number of patients (%), unless otherwise indicated.
b
Poor prognosis, while not a true “goal of care” was part of the documentation template for the goals of care section.
c
One patient with no formal examination for brain death was noted as having brainstem disruption.
DOD, day of death; CPR, cardiopulmonary resuscitation; EOL, end of life; Max, maximum value; Min, minimum value; No., number of; PICU, pediatric intensive care unit; POST, physician order for scope of treatment; SD, standard deviation; TOD, time of death.