Fraser, LK, Fleming, S orcid.org/0000-0002-7655-4806 and Parslow, R orcid.org/0000-0002-3945-5294 (2018) Changing place of death in children who died after discharge from paediatric intensive care units: A national, data linkage study. Palliative Medicine, 32 (2). pp. 337-346. ISSN 0269-2163
Abstract
Background: Although child mortality is decreasing, more than half of all deaths in childhood occur in children with a life-limiting condition whose death may be expected. Aim: To assess trends in place of death and identify characteristics of children who died in the community after discharge from paediatric intensive care unit. Design: National data linkage study. Setting/participants: All children resident in England and Wales when admitted to a paediatric intensive care unit in the United Kingdom (1 January 2004 and 31 December 2014) were identified in the Paediatric Intensive Care Audit Network dataset. Linkage to death certificate data was available up to the end of 2014. Place of death was categorised as hospital (hospital or paediatric intensive care unit) or community (hospice, home or other) for multivariable logistic modelling. Results: The cohort consisted of 110,328 individuals. In all, 7709 deaths occurred after first discharge from paediatric intensive care unit. Among children dying, the percentage in-hospital at the time of death decreased from 83.8% in 2004 to 68.1% in 2014; 852 (0.8%) of children were discharged to palliative care. Children discharged to palliative care were eight times more likely to die in the community than children who died and had not been discharged to palliative care (odds ratio = 8.06 (95% confidence interval = 6.50–10.01)). Conclusions: The proportion of children dying in hospital is decreasing, but a large proportion of children dying after discharge from paediatric intensive care unit continue to die in hospital. The involvement of palliative care at the point of discharge has the potential to offer choice around place of care and death for these children and families.
Metadata
Item Type: | Article |
---|---|
Authors/Creators: |
|
Copyright, Publisher and Additional Information: | © The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (http://www.uk.sagepub.com/aboutus/openaccess.htm). |
Keywords: | Paediatric intensive care unit, palliative care, place of death, hospice, child |
Dates: |
|
Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Epidemiology and Biostatistics (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 22 May 2017 11:53 |
Last Modified: | 20 Mar 2018 09:18 |
Status: | Published |
Publisher: | SAGE Publications |
Identification Number: | 10.1177/0269216317709711 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:116676 |