Pediatric end-of-life care for Taiwanese children who died as a result of cancer from 2001 through 2006

Siew Tzuh Tang, Yen Ni Hung, Tsang Wu Liu, Dong Tsamn Lin, Yueh Chih Chen, Shiao Chi Wu, Tsui Hsia Hsu

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Purpose: Patterns of aggressive end-of-life (EOL) care have not been extensively explored in a pediatric cancer population, especially outside Western countries. The purpose of this population-based study was to examine trends in aggressive pediatric EOL cancer care in Taiwan. Methods: Retrospective cohort study that used administrative data among 1,208 pediatric cancer decedents from 2001 through 2006. Results: Taiwanese pediatric cancer patients who died in 2001 through 2006 received aggressive EOL care. The majority of these patients in their last month of life continued to receive chemotherapy (52.5%), used intensive care (57.0%), underwent intubation (40.9%), underwent mechanical ventilation (48.2%), or spent greater than 14 days (69.5%) in hospital, and they died in an acute care hospital (78.8%). Of these pediatric cancer patients, one in four received cardiopulmonary resuscitation in the month before they died, and only 7.2% received hospice care. Among those who received hospice care, 21.8% started such care within the last 3 days of life. This pattern of aggressive EOL care did not change over the study period except for significantly decreased intubation in the last month of life. Conclusion: Continued chemotherapy and heavy use of life-sustaining treatments in the last month of life coupled with lack of hospice care to support Taiwanese pediatric cancer patients dying at home may lead to multiple unplanned health care encounters, prolonged hospitalization at EOL, and eventual death in an acute care hospital for the majority of these patients. Future research should design interventions that enable Taiwanese pediatric cancer patients to receive EOL care that best meets the individual or the parental needs and preferences.

Original languageEnglish
Pages (from-to)890-894
Number of pages5
JournalJournal of Clinical Oncology
Volume29
Issue number7
DOIs
Publication statusPublished - Mar 1 2011
Externally publishedYes

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Terminal Care
Pediatrics
Hospice Care
Neoplasms
Intubation
Drug Therapy
Cardiopulmonary Resuscitation
Critical Care
Taiwan
Artificial Respiration
Population
Hospitalization
Cohort Studies
Research Design
Retrospective Studies
Delivery of Health Care

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Tang, S. T., Hung, Y. N., Liu, T. W., Lin, D. T., Chen, Y. C., Wu, S. C., & Hsu, T. H. (2011). Pediatric end-of-life care for Taiwanese children who died as a result of cancer from 2001 through 2006. Journal of Clinical Oncology, 29(7), 890-894. https://doi.org/10.1200/JCO.2010.32.5639

Pediatric end-of-life care for Taiwanese children who died as a result of cancer from 2001 through 2006. / Tang, Siew Tzuh; Hung, Yen Ni; Liu, Tsang Wu; Lin, Dong Tsamn; Chen, Yueh Chih; Wu, Shiao Chi; Hsu, Tsui Hsia.

In: Journal of Clinical Oncology, Vol. 29, No. 7, 01.03.2011, p. 890-894.

Research output: Contribution to journalArticle

Tang, Siew Tzuh ; Hung, Yen Ni ; Liu, Tsang Wu ; Lin, Dong Tsamn ; Chen, Yueh Chih ; Wu, Shiao Chi ; Hsu, Tsui Hsia. / Pediatric end-of-life care for Taiwanese children who died as a result of cancer from 2001 through 2006. In: Journal of Clinical Oncology. 2011 ; Vol. 29, No. 7. pp. 890-894.
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abstract = "Purpose: Patterns of aggressive end-of-life (EOL) care have not been extensively explored in a pediatric cancer population, especially outside Western countries. The purpose of this population-based study was to examine trends in aggressive pediatric EOL cancer care in Taiwan. Methods: Retrospective cohort study that used administrative data among 1,208 pediatric cancer decedents from 2001 through 2006. Results: Taiwanese pediatric cancer patients who died in 2001 through 2006 received aggressive EOL care. The majority of these patients in their last month of life continued to receive chemotherapy (52.5{\%}), used intensive care (57.0{\%}), underwent intubation (40.9{\%}), underwent mechanical ventilation (48.2{\%}), or spent greater than 14 days (69.5{\%}) in hospital, and they died in an acute care hospital (78.8{\%}). Of these pediatric cancer patients, one in four received cardiopulmonary resuscitation in the month before they died, and only 7.2{\%} received hospice care. Among those who received hospice care, 21.8{\%} started such care within the last 3 days of life. This pattern of aggressive EOL care did not change over the study period except for significantly decreased intubation in the last month of life. Conclusion: Continued chemotherapy and heavy use of life-sustaining treatments in the last month of life coupled with lack of hospice care to support Taiwanese pediatric cancer patients dying at home may lead to multiple unplanned health care encounters, prolonged hospitalization at EOL, and eventual death in an acute care hospital for the majority of these patients. Future research should design interventions that enable Taiwanese pediatric cancer patients to receive EOL care that best meets the individual or the parental needs and preferences.",
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