Pediatric palliative care: data of the first 13 months of operation

Authors : Fatma Zehra ÖZTEK ÇELEBİ, Şanlıay ŞAHİN

Pages : 656-661

Doi:10.32322/jhsm.948938

View : 21 | Download : 9

Publication Date : 2021-09-05

Article Type : Research Paper

Abstract :Aim: Children with complex chronic conditions are main candidates for pediatric palliative care insert ignore into journalissuearticles values(PPC);. Despite the proven advantages of palliative care for these children, the literature lacks on the adequate description of the pediatric population receiving this care. The aim of this study was to describe demographic characteristics of the patients, to examine the patient survival and the factors affecting patient survival. To our knowledge, this is the first description of the cohort of children and adolescents on PPC in Turkey. Materials and methods: This retrospective chart review study examined patients receiving palliative care at University of Health Sciences, Dr. Sami Ulus Maternity and Children`s Training and Research Hospital between 2.12.2019 and 31.12.2020. The data of demographics, underlying diagnosis, medical technology dependence, symptoms at admission, number of hospitalizations, number of emergency department insert ignore into journalissuearticles values(ED); admissions were collected. Results: 70 male and 66 female patients were admitted 259 times during the observation period. The median length of hospital stay was 7 days. Median age at referral was 44 months insert ignore into journalissuearticles values(range:2.7-215);. Fifty-one patients insert ignore into journalissuearticles values(37.5%); were younger than 2 years of age. Neurological diseases were the most prevalent disease group. 56 of our patients insert ignore into journalissuearticles values(41%); had a tracheostomy. 82 patients insert ignore into journalissuearticles values(60.3%); needed respiratory support. Fifty of them were ventilated through home-type mechanical ventilator. Only 28 patients insert ignore into journalissuearticles values(20.6%); could be fed through oral route. Nasogastric tube insert ignore into journalissuearticles values(n=84, 61.8%); was the main device used by children who needed nutritional support. 52% of patients were referred from ED. Most prevalent symptoms of the patients at admission were dyspnea and tachypnea. 151 of the patients insert ignore into journalissuearticles values(58.3%); were diagnosed with infection, the most common infection was lower respiratory tract infection insert ignore into journalissuearticles values(n=103, 39.8%);. Of 259 PPC center admissions 224 insert ignore into journalissuearticles values(86.5%); were discharged to home. Twenty-seven children insert ignore into journalissuearticles values(20%); died during study period. Nineteen of deceased patients died in intensive care unit insert ignore into journalissuearticles values(70%);. The 1-year survival rate of the patients was 78.1%. In logistic regression analysis the risk of death was 3.4 times higher in patients ≤2 years of age insert ignore into journalissuearticles values(CI: 1.4-8.8, p=0.01); and in patients with respiratory support insert ignore into journalissuearticles values(CI: 1.1-11.0, p=0.04);. Conclusion: Describing the cohort of patients on PPC provides important information on the complexity of their disease process, types of their illnesses, medical technology dependence, re-admission rates, mortality status and factors affecting mortality. Important research has been done but pediatric palliative care is still in infancy in Turkey. Future prospective research is needed to understand the unique challenges of PPC.
Keywords : End of Life, Medical Devices, Multiple Chronic Health Conditions, Survival