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Palliative care in pediatric patients with central nervous system cancer: Descriptive and comparative study

Published online by Cambridge University Press:  12 August 2022

Iñigo de Noriega*
Affiliation:
Pediatric Palliative Care Unit, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain
Ricardo Martino Alba
Affiliation:
Pediatric Palliative Care Unit, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain
Blanca Herrero Velasco
Affiliation:
Department of Pediatric Oncology, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain
Luis Madero López
Affiliation:
Department of Pediatric Oncology, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain
Álvaro Lassaletta
Affiliation:
Department of Pediatric Oncology, Hospital Infantil Universitario del Niño Jesús, Madrid, Spain
*
Author for Correspondence: Iñigo de Noriega, Pediatric Palliative Care Unit, Hospital Niño Jesús, Avenida Menendez Pelayo, 65, 28009-Madrid, Spain. E-mail: iigo.noriega@gmail.com

Abstract

Objectives

Data regarding the palliative needs of pediatric patients with central nervous system (CNS) cancer are scarce. We aimed to describe the attention provided by a pediatric palliative care (PPC) team to patients with CNS cancer and the differences in care compared to patients who did not receive PPC.

Method

This retrospective study was based on the clinical records of deceased patients with CNS cancer attended by a PPC team over 10 years, analyzing their trajectory and provision of PPC, including medical, psychological, social, and nursing interventions. Furthermore, we compared the last month of life care of deceased patients with CNS cancer in the same institution, based on whether they were attended by the PPC team.

Results

Of 71 patients, 59 received PPC, with a median of 1.6 months (Interquartile range: 0.6–5.2) from referral to death. Home hospitalization was provided to 84.8%, nursing interventions were registered in 89.8%, psychological characteristics in 84.7%, and social interventions in 88.1%. The most common symptoms were pain, dyspnea, and constipation. When comparing patients from the same hospital who received PPC (n = 36) with those who did not (n = 12), the former spent fewer days in the hospital in their last month and last week (p < 0.01) and were more likely to die at home (50% vs. 0%; p < 0.01).

Significance of results

Patients with CNS cancer show various medical, social, and psychological needs during end-of-life care. Providing specific PPC interventions decreased the number of days spent at the hospital and increased the rate of death at home.

Type
Original Article
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press

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