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Prevalence of specialised palliative care consultation for eligible children within a paediatric cardiac ICU

Published online by Cambridge University Press:  18 February 2021

Claudia Delgado-Corcoran Open the ORCID record for Claudia Delgado-Corcoran [Opens in a new window] ,
Erin E. Bennett ,
Stephanie A. Bodily ,
Sarah E. Wawrzynski ,
Danielle Green ,
Dominic Moore ,
Lawrence J. Cook  and
Lenora M. Olson
Claudia Delgado-Corcoran*
Affiliation:
Division of Critical Care, Department of Pediatrics, University of Utah, 295 Chipeta Way, PO BOX 581289, Salt Lake City, UT, 84108, USA Division of Pediatric Palliative Care, Department of Pediatrics, University of Utah, 100 N. Mario Capecchi Dr. Salt Lake City, UT, 84113, USA
Erin E. Bennett
Affiliation:
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
Stephanie A. Bodily
Affiliation:
Pediatric Critical Care Services, Primary Children’s Hospital, Intermountain Healthcare, 100 N. Mario Capecchi Dr. Salt Lake City, UT, 84113, USA
Sarah E. Wawrzynski
Affiliation:
Pediatric Critical Care Services, Primary Children’s Hospital, Intermountain Healthcare, 100 N. Mario Capecchi Dr. Salt Lake City, UT, 84113, USA
Danielle Green
Affiliation:
Division of Critical Care, Department of Pediatrics, University of Utah, 295 Chipeta Way, PO BOX 581289, Salt Lake City, UT, 84108, USA
Dominic Moore
Affiliation:
Division of Pediatric Palliative Care, Department of Pediatrics, University of Utah, 100 N. Mario Capecchi Dr. Salt Lake City, UT, 84113, USA
Lawrence J. Cook
Affiliation:
Division of Critical Care, Department of Pediatrics, University of Utah, 295 Chipeta Way, PO BOX 581289, Salt Lake City, UT, 84108, USA
Lenora M. Olson
Affiliation:
Division of Critical Care, Department of Pediatrics, University of Utah, 295 Chipeta Way, PO BOX 581289, Salt Lake City, UT, 84108, USA
*
Author for correspondence: Claudia Delgado-Corcoran, MD, MPH, University of Utah, 295 Chipeta Way, PO BOX 581289, Salt Lake City, UT, 84108, USA. Tel: 801-599-0085; Fax: 801-662-2469. E-mail: Claudia.delgado@hsc.utah.edu
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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.

Keywords

Paediatricspalliative carecongenital heart defectsintensive care unitCenter to Advance Palliative Care
Type
Original Article
Information
Cardiology in the Young , Volume 31 , Issue 9 , September 2021 , pp. 1458 - 1464
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Copyright
© The Author(s), 2021. Published by Cambridge University Press

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