Prevalence of specialised palliative care consultation for eligible children within a paediatric cardiac ICU.
Prevalence of specialised palliative care consultation for eligible children within a paediatric cardiac ICU.
复制标题
DOI：
10.1017/s1047951121000433
复制
发表时间：
2021-09
影响因子：
1
通讯作者：
Olson LM
中科院分区：
文献类型：
--
作者：
Delgado-Corcoran C;Bennett EE;Bodily SA;Wawrzynski SE;Green D;Moore D;Cook LJ;Olson LM
回顾性地将高级姑息治疗中心的标准应用于在心脏 ICU 接受治疗的一组儿童，并将接受姑息治疗咨询的儿童与符合资格但未接受姑息治疗咨询的儿童进行比较。对 2014 年 1 月至 2017 年 6 月期间入住心脏 ICU 的儿童的医疗记录进行了审查。选定的标准包括心脏 ICU 住院时间 > 14 天和/或 6 个月内住院次数≥ 3 次。 288 名符合条件的儿童中，有 17%（n = 48）接受了咨询。接受会诊的儿童在心脏 ICU（27 天与 17 天；p < 0.001）和住院时间（91 天与 35 天；p < 0.001）的住院时间较长，首次住院结束时（3 vs.1；p < 0.001）和研究结束时（4 vs.2；p < 0.001）慢性病更加复杂，死亡率较高（42% vs 7%；p < 0.001）。 0.001）与未咨询组相比。在142名产前诊断儿童中，只有1名接受了产前咨询，23名接受了产后咨询。接受咨询的儿童 (n = 48) 接受咨询时年龄已近 2 个月。不到四分之一的符合条件的儿童接受了咨询。会诊通常发生在医疗复杂性、死亡风险高且年龄较大的背景下，这表明心脏 ICU 中更多、更早地参与儿科姑息治疗的潜在机会。确定咨询患者的筛选标准可能会增加心脏 ICU 姑息治疗服务的使用。
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. 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. 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. 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.