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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
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Factors associated with death in the emergency department among children dying of complex chronic conditions:

Marie-Hélène Guertin1, Linda Côté-Brisson, Diane Major

  • 1Direction des Systèmes de Soins et Politiques Publiques, Institut National de Santé Publique du Québec, Québec, Canada.

Journal of Palliative Medicine
|July 23, 2009
PubMed

Insights

Approximately 14% of children with complex chronic conditions died in an emergency department (ED). Children not hospitalized prior to death were at higher risk for ED deaths, highlighting the need for better advanced care planning.

Area of Science:

  • Pediatric critical care medicine
  • Public health research
  • Healthcare outcomes analysis

Background:

  • Complex chronic conditions (CCCs) pose significant end-of-life care challenges for children.
  • Emergency departments (EDs) are a critical interface for pediatric end-of-life care.
  • Understanding patterns of death in EDs is crucial for improving care quality.

Purpose of the Study:

  • To quantify the proportion of deaths occurring in EDs among children with CCCs.
  • To identify demographic and clinical factors associated with ED deaths in this population.

Main Methods:

  • Population-based study utilizing administrative databases in Quebec (1997-2001).
  • Inclusion of all children aged 1-19 years who died from CCCs.
  • Analysis of factors including year of death, sociodemographics, and prior hospitalizations.

Main Results:

  • 13.8% of all pediatric deaths from CCCs occurred in an ED.
  • Children not hospitalized in the week prior to death had a 21.7% rate of ED death.
  • Higher odds of ED death were observed for cardiovascular, congenital/genetic, and neuromuscular conditions; increased odds over time; lower odds with tertiary pediatric center hospitalization.

Conclusions:

  • EDs are significant sites for pediatric end-of-life care for children with CCCs.
  • Tertiary pediatric centers' multidisciplinary teams may improve prognosis assessment and advanced care planning.
  • Further research into optimizing end-of-life care pathways for these vulnerable children is warranted.
Abstract

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