Current status of intensive end-of-life care in children with hematologic malignancy: a population-based study.
Current status of intensive end-of-life care in children with hematologic malignancy: a population-based study.
复制标题
DOI：
10.1186/s12904-021-00776-5
复制
发表时间：
2021-06-07
影响因子：
3.1
通讯作者：
Kizawa Y
中科院分区：
文献类型：
--
作者：
Yotani N;Shinjo D;Kato M;Matsumoto K;Fushimi K;Kizawa Y
与实体瘤患者相比，血液恶性肿瘤成人患者接受姑息治疗的可能性较小，接受强化抗癌治疗的可能性更大，直至生命结束，但关于血液恶性肿瘤儿童的生命结束护理（EOLC）质量的数据有限。为了提高恶性血液病儿童EOLC的质量，本研究的目的是（i）比较恶性血液病儿童和实体瘤儿童的强化EOLC;（ii）描述恶性血液病儿童强化EOLC的相关因素。我们回顾性分析了2012年4月至2016年3月期间在日本使用诊断程序组合按日支付系统在医院死亡的0至18岁癌症患者。重症住院EOLC的指标定义为生命的最后30天内入住重症监护室、心肺复苏（CPR）、插管和/或机械通气、血液透析或体外膜肺氧合，或过去14天内静脉化疗。我们使用回归模型确定了与密集EOLC相关的因素。还从数据库中获得了有关输血使用的数据。在1199例患者中，433例（36%）患有血液学恶性肿瘤。恶性血液病患儿比实体瘤患儿更容易接受气管插管和/或机械通气（37.9%对23.5%），入住重症监护室（21.9% vs. 7.2%），心肺复苏术（14.5% vs 7.7%），血液透析（13.2% vs. 3.1%）或皮质外膜氧合（2.5%对0.4%），或静脉化疗（47.8%对18.4%;所有P <0.01）在他们生命的最后14天。超过90%的血液恶性肿瘤儿童在生命的最后7天内接受了输血。对于血液系统恶性肿瘤，5岁以下的年龄与CPR和≥ 2个强化EOLC指标相关。住院时间越长，≥ 2个强化EOLC指标的几率越低。与实体瘤儿童相比，血液系统恶性肿瘤儿童更有可能接受强化EOLC。年龄较小和住院时间较短可能与血液系统恶性肿瘤儿童的强化EOLC相关。
Adult patients with hematologic malignancies are less likely to receive palliative care and more likely to accept intensive anti-cancer treatments until end-of-life than those with solid tumors, but limited data are available regarding the quality of end-of-life care (EOLC) for children with hematologic malignancies. To improve the quality of EOLC for children with hematologic malignancies, the aims of this study were (i) to compare intensive EOLC between children with hematologic malignancies and those with solid tumors; and (ii) to describe factors associated with intensive EOLC in children with hematologic malignancies. We retrospectively reviewed 0- to 18-year-old patients with cancer, who died in hospital between April 2012 and March 2016 in Japan using the Diagnosis Procedure Combination per-diem payment system. Indicators of intensive inpatient EOLC were defined as intensive care unit admission, cardiopulmonary resuscitation (CPR), intubation and/or mechanical ventilation, hemodialysis, or extra-corporeal membrane oxygenation in the last 30 days of life, or intravenous chemotherapy in the last 14 days. We determined factors associated with intensive EOLC using regression models. Data regarding use of blood transfusion were also obtained from the database. Among 1199 patients, 433 (36%) had hematological malignancies. Children with hematologic malignancies were significantly more likely than those with solid tumors to have intubation and/or mechanical ventilation (37.9% vs. 23.5%), intensive care unit admission (21.9% vs. 7.2%), CPR (14.5% vs. 7.7%), hemodialysis (13.2% vs. 3.1%) or extra-corporeal membrane oxygenation (2.5% vs. 0.4%) in their last 30 days, or intravenous chemotherapy (47.8% vs. 18.4%; all P < .01) within their last 14 days of life. Over 90% of children with hematological malignancies received a blood transfusion within the last 7 days of life. For hematological malignancies, age under 5 years was associated with CPR and ≥ 2 intensive EOLC indicators. Longer hospital stays had decreased odds of ≥ 2 intensive EOLC indicators. Children with hematologic malignancies are more likely to receive intensive EOLC compared to those with solid tumors. A younger age and shorter hospital stay might be associated with intensive EOLC in children with hematologic malignancies.
登录
查看更多内容
影响因子：
--
作者：
Hoell, Jessica I.;Warfsmann, Jens;Kuhlen, Michaela
通讯作者：
Kuhlen, Michaela
影响因子：
50.5
作者：
Tang, S. T.;Wu, S. -C.;Liu, T. -W.
通讯作者：
Liu, T. -W.
影响因子：
--
作者：
Odejide, Oreofe O.;Coronado, Diana Y. Salas;Abel, Gregory A.
通讯作者：
Abel, Gregory A.
DOI：
10.1016/s2352-3026(17)30052-2
发表时间：
2017-05
期刊：
The Lancet. Haematology
影响因子：
--
作者：
Bonaventure A;Harewood R;Stiller CA;Gatta G;Clavel J;Stefan DC;Carreira H;Spika D;Marcos-Gragera R;Peris-Bonet R;Piñeros M;Sant M;Kuehni CE;Murphy MFG;Coleman MP;Allemani C;CONCORD Working Group
通讯作者：
CONCORD Working Group
DOI：
10.1111/j.1532-5415.2000.tb03120.x
发表时间：
2000-05-01
影响因子：
6.3
作者：
McCarthy, EP;Phillips, RS;Lynn, J
通讯作者：
Lynn, J