Claudia Delgado-Corcoran1,2, Erin E Bennett3, Stephanie A Bodily4, Sarah E Wawrzynski4, Danielle Green1, Dominic Moore2, Lawrence J Cook1, Lenora M Olson1. 1. Division of Critical Care, Department of Pediatrics, University of Utah, 295 Chipeta Way, PO BOX 581289, Salt Lake City, UT, 84108, USA. 2. Division of Pediatric Palliative Care, Department of Pediatrics, University of Utah, 100 N. Mario Capecchi Dr. Salt Lake City, UT, 84113, USA. 3. Division of Critical Care, Department of Pediatrics, University of Arkansas for Medical Sciences, Arkansas Children's Hospital. 1 Children's Way, Little Rock, AR, 72202, USA. 4. Pediatric Critical Care Services, Primary Children's Hospital, Intermountain Healthcare, 100 N. Mario Capecchi Dr. Salt Lake City, UT, 84113, USA.
Abstract
OBJECTIVE: Retrospectively apply criteria from Center to Advance Palliative Care to a cohort of children treated in a cardiac ICU and compare children who received a palliative care consultation to those who were eligible for but did not receive one. METHODS: Medical records of children admitted to a cardiac ICU between January 2014 and June 2017 were reviewed. Selected criteria include cardiac ICU length of stay >14 days and/or ≥ 3 hospitalisations within a 6-month period. MEASUREMENTS AND RESULTS: A consultation occurred in 17% (n = 48) of 288 eligible children. Children who received a consult had longer cardiac ICU (27 days versus 17 days; p < 0.001) and hospital (91 days versus 35 days; p < 0.001) lengths of stay, more complex chronic conditions at the end of first hospitalisation (3 versus1; p < 0.001) and the end of the study (4 vs.2; p < 0.001), and higher mortality (42% versus 7%; p < 0.001) when compared with the non-consulted group. Of the 142 pre-natally diagnosed children, only one received a pre-natal consult and 23 received it post-natally. Children who received a consultation (n = 48) were almost 2 months of age at the time of the consult. CONCLUSIONS: Less than a quarter of eligible children received a consultation. The consultation usually occurred in the context of medical complexity, high risk of mortality, and at an older age, suggesting potential opportunities for more and earlier paediatric palliative care involvement in the cardiac ICU. Screening criteria to identify patients for a consultation may increase the use of palliative care services in the cardiac ICU.
OBJECTIVE: Retrospectively apply criteria from Center to Advance Palliative Care to a cohort of children treated in a cardiac ICU and compare children who received a palliative care consultation to those who were eligible for but did not receive one. METHODS: Medical records of children admitted to a cardiac ICU between January 2014 and June 2017 were reviewed. Selected criteria include cardiac ICU length of stay >14 days and/or ≥ 3 hospitalisations within a 6-month period. MEASUREMENTS AND RESULTS: A consultation occurred in 17% (n = 48) of 288 eligible children. Children who received a consult had longer cardiac ICU (27 days versus 17 days; p < 0.001) and hospital (91 days versus 35 days; p < 0.001) lengths of stay, more complex chronic conditions at the end of first hospitalisation (3 versus1; p < 0.001) and the end of the study (4 vs.2; p < 0.001), and higher mortality (42% versus 7%; p < 0.001) when compared with the non-consulted group. Of the 142 pre-natally diagnosed children, only one received a pre-natal consult and 23 received it post-natally. Children who received a consultation (n = 48) were almost 2 months of age at the time of the consult. CONCLUSIONS: Less than a quarter of eligible children received a consultation. The consultation usually occurred in the context of medical complexity, high risk of mortality, and at an older age, suggesting potential opportunities for more and earlier paediatric palliative care involvement in the cardiac ICU. Screening criteria to identify patients for a consultation may increase the use of palliative care services in the cardiac ICU.
Entities:
Keywords:
Center to Advance Palliative Care; Paediatrics; congenital heart defects; intensive care unit; palliative care
Authors: Judith E Nelson; J Randall Curtis; Colleen Mulkerin; Margaret Campbell; Dana R Lustbader; Anne C Mosenthal; Kathleen Puntillo; Daniel E Ray; Rick Bassett; Renee D Boss; Karen J Brasel; Jennifer A Frontera; Ross M Hays; David E Weissman Journal: Crit Care Med Date: 2013-10 Impact factor: 7.598
Authors: Katie M Moynihan; Jennifer M Snaman; Erica C Kaye; Wynne E Morrison; Aaron G DeWitt; Loren D Sacks; Jess L Thompson; Jennifer M Hwang; Valerie Bailey; Deborah A Lafond; Joanne Wolfe; Elizabeth D Blume Journal: Pediatrics Date: 2019-08 Impact factor: 7.124
Authors: Jennifer S Temel; Joseph A Greer; Areej El-Jawahri; William F Pirl; Elyse R Park; Vicki A Jackson; Anthony L Back; Mihir Kamdar; Juliet Jacobsen; Eva H Chittenden; Simone P Rinaldi; Emily R Gallagher; Justin R Eusebio; Zhigang Li; Alona Muzikansky; David P Ryan Journal: J Clin Oncol Date: 2016-12-28 Impact factor: 44.544
Authors: Renee Boss; Judith Nelson; David Weissman; Margaret Campbell; Randall Curtis; Jennifer Frontera; Michelle Gabriel; Dana Lustbader; Anne Mosenthal; Colleen Mulkerin; Kathleen Puntillo; Daniel Ray; Rick Bassett; Karen Brasel; Ross Hays Journal: Pediatr Crit Care Med Date: 2014-10 Impact factor: 3.624
Authors: Claudia Delgado-Corcoran; Sarah E Wawrzynski; Erin E Bennett; Danielle Green; Stephanie Bodily; Dominic Moore; Lawrence J Cook; Lenora M Olson Journal: Pediatr Crit Care Med Date: 2020-05 Impact factor: 3.624
Authors: Lisa C Lindley; Radion Svynarenko; Kim Mooney-Doyle; Annette Mendola; Wendy C Naumann; Robin Harris Journal: J Cardiovasc Nurs Date: 2021-12-21 Impact factor: 2.468