Related Experiment Video
Updated: May 30, 2025
Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies
Published on: February 6, 2019
Differences in Inpatient Palliative Care Consultation During the Terminal Admission for Pediatric Neuro-Oncology
Chinwe S Udemgba1, Brett K Palama2, Wendy Darlington2,3
1Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
Insights
Palliative care consultations for pediatric neuro-oncology patients are linked to less intensive hospital care, including fewer intensive care unit admissions and mechanical ventilation. This highlights the importance of palliative care for terminally ill children.
Area of Science:
- Pediatric Oncology
- Palliative Care
- Health Services Research
Background:
- Pediatric neuro-oncology patients face high mortality rates.
- The role of palliative care in end-of-life care for these children is crucial.
- Understanding disparities in palliative care access is essential.
Purpose of the Study:
- To examine the relationship between palliative care consultation and the intensity of in-hospital care for pediatric neuro-oncology patients.
- To determine if racial and ethnic differences are associated with palliative care consultations during terminal admissions.
Main Methods:
- Retrospective observational study using the Pediatric Health Information System (PHIS) database.
- Included patients under 18 with a brain tumor diagnosis and terminal admission between 2017-2021.
- Analyzed palliative care consultation rates and intensity of care metrics.
Main Results:
- 63% of eligible patients received an inpatient palliative care consultation.
- No significant differences in consultation rates across racial groups.
- Hispanic patients had a ~10% higher consultation rate than non-Hispanic patients.
- Palliative care consultation was associated with lower rates of PICU admission, mechanical ventilation, and TPN use.
Conclusions:
- Palliative care consultation in pediatric neuro-oncology is associated with reduced intensity of end-of-life hospital care.
- Palliative care may support enhanced decision-making for patients and families.
- Integrating palliative care is vital for terminally ill children with neuro-oncological diagnoses.
Abstract:
Pediatric neuro-oncology patients have one of the highest mortality rates among all children with cancer. Our study examines the potential relationship between palliative care consultation and intensity of in-hospital care and determines if racial and ethnic differences are associated with palliative care consultations during their terminal admission. Retrospective observational study using the Pediatric Health Information System (PHIS) database with data from U.S. children's hospitals. PHIS was queried for patients under 18 years of age who received a diagnosis of brain tumor and had their terminal admission between January 1, 2017 and December 31, 2021. Of the 567 patients who fit the inclusion criteria, 359 (63%) patients had an inpatient palliative care consultation during their terminal hospital stay. There were no statistically significant differences seen when comparing palliative care consultation rates among racial groups. When comparing the ethnicity variables, patients in the Hispanic group had approximately a 10% higher rate of palliative care consultations than their non-Hispanic counterpart. Patients with palliative care consultations had a lower percentage of PICU admission (64.9 vs 83.2), mechanical ventilation (51.0 vs 76.0), and TPN use (18.1 vs 25.5) despite having similar lengths of stay. Pediatric neuro-oncology patients who received a palliative care consultation during their terminal hospital stay had lower intensity care (lower rates PICU admission, mechanical ventilation use, and TPN use) despite having similar lengths of stay. This may reflect the enhanced decision-making support for the patients and their families so that they may consider all options. Children facing a terminal illness and their families deserve access to optimal supportive services. This study highlights the importance of integrating palliative care in hospital admissions of terminally ill children with neuro-oncological diagnoses.
More Related Videos
Related Concept Videos
01:25Continuing Care
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's...
01:27Ethical Issues
Ethical Concerns in Healthcare:
01:21Planning Nursing Care I
01:30Specialized Care Centers and Settings-I
Daycare centers
They provide several functions. Some facilities care for healthy newborns and children whose parents work, while others are medically focused and care for...
01:17Ethical Dilemmas I
Let us explore some examples to understand the potentially complex moral decisions nurses face.
Take the case of caring for minors, particularly in areas related to reproductive...