Sanne Lausen Wolff1, Christian Fynbo Christiansen2, Mette Kjaergaard Nielsen3, Soeren Paaske Johnsen4, Henrik Schroeder5, Mette Asbjoern Neergaard6. 1. Palliative Care Team, Department of Oncology, Aarhus University Hospital, Palle Juul Jensens Blvd. 99, 8200, Aarhus N, Denmark. sanwol@rm.dk. 2. Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark. 3. Research Unit of General Practice and Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus C, Denmark. 4. Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, 9000, Aalborg, Denmark. 5. Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Palle Juul Jensens Blvd. 99, 8200, Aarhus N, Denmark. 6. Palliative Care Team, Department of Oncology, Aarhus University Hospital, Palle Juul Jensens Blvd. 99, 8200, Aarhus N, Denmark.
Abstract
Through a systematic review and meta-analyses, we aimed to determine predictors for place of death among children. We searched online databases for studies published between 2008 and 2019 comprising original quantitative data on predictors for place of death among children. Data regarding study design, population characteristics and results were extracted from each study. Meta-analyses were conducted using generic inverse variance method with random effects. Fourteen cohort studies met the inclusion criteria, comprising data on 106,788 decedents. Proportions of home death varied between countries and regions from 7% to 45%. Lower age was associated with higher odds of hospital death in eight studies (meta-analysis was not possible). Children categorised as non-white were less likely to die at home compared to white (pooled OR 0.6; 95% CI 0.5-0.7) as were children of low socio-economic position versus high (pooled OR 0.7; 95% CI 0.6-0.9). Compared to patients with cancer, children with non-cancer diagnoses had lower odds of home death (pooled OR 0.5; 95% CI 0.5-0.5). Conclusion: Country and region of residence, older age of the child, high socio-economic position, 'white' ethnicity and cancer diagnoses appear to be independent predictors of home death among children. What is Known: • Home is often considered an indicator of quality in end-of-life care. • Most terminally ill children die in hospitals. What is New: • Through a systematic review and meta-analyses, this study examined predictors for place of death among children. • Country and region of residence, older age of the child, high socio-economic position, white ethnicity and having a cancer diagnosis appear to be independent predictors of home death among terminally ill children.
Through a systematic review and meta-analyses, we aimed to determine predictors for place of death among children. We searched online databases for studies published between 2008 and 2019 comprising original quantitative data on predictors for place of death among children. Data regarding study design, population characteristics and results were extracted from each study. Meta-analyses were conducted using generic inverse variance method with random effects. Fourteen cohort studies met the inclusion criteria, comprising data on 106,788 decedents. Proportions of home death varied between countries and regions from 7% to 45%. Lower age was associated with higher odds of hospital death in eight studies (meta-analysis was not possible). Children categorised as non-white were less likely to die at home compared to white (pooled OR 0.6; 95% CI 0.5-0.7) as were children of low socio-economic position versus high (pooled OR 0.7; 95% CI 0.6-0.9). Compared to patients with cancer, children with non-cancer diagnoses had lower odds of home death (pooled OR 0.5; 95% CI 0.5-0.5). Conclusion: Country and region of residence, older age of the child, high socio-economic position, 'white' ethnicity and cancer diagnoses appear to be independent predictors of home death among children. What is Known: • Home is often considered an indicator of quality in end-of-life care. • Most terminally ill children die in hospitals. What is New: • Through a systematic review and meta-analyses, this study examined predictors for place of death among children. • Country and region of residence, older age of the child, high socio-economic position, white ethnicity and having a cancer diagnosis appear to be independent predictors of home death among terminally ill children.
Entities:
Keywords:
Child; Palliative care; Place of death; Systematic review
Authors: Gregorio Zuniga-Villanueva; Jorge Alberto Ramos-Guerrero; Monica Osio-Saldaña; Jessica A Casas; Joan Marston; Regina Okhuysen-Cawley Journal: Children (Basel) Date: 2021-03-23