Transition to noncurative end-of-life care in paediatric oncology – a nationwide follow-up in Sweden
Article first published online: 16 APR 2013
©2013 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd
Volume 102, Issue 7, pages 744–748, July 2013
How to Cite
Jalmsell, L., Forslund, M., Hansson, M. G., Henter, J.-I., Kreicbergs, U. and Frost, B.-M. (2013), Transition to noncurative end-of-life care in paediatric oncology – a nationwide follow-up in Sweden. Acta Paediatrica, 102: 744–748. doi: 10.1111/apa.12242
- Issue published online: 30 MAY 2013
- Article first published online: 16 APR 2013
- Accepted manuscript online: 5 APR 2013 04:26AM EST
- Manuscript Accepted: 14 MAR 2013
- Manuscript Revised: 18 FEB 2013
- Manuscript Received: 21 DEC 2012
- Children with cancer;
- Paediatric oncology;
- Palliative care
To estimate whether and when children dying from a malignancy are recognized as being beyond cure and to study patterns of care the last weeks of life.
A nationwide retrospective medical record review was conducted. Medical records of 95 children (60% of eligible children) who died from a malignancy 2007–2009 in Sweden were studied.
Eighty-three children (87%) were treated without curative intent at the time of death. Children with haematological malignancies were less likely to be recognized as being beyond cure than children with brain tumours [relative risks (RR) 0.7; 95% confidence interval (CI) 0.6–0.9] or solid tumours (RR 0.8; 0.6–1.0). The transition to noncurative care varied from the last day of life to over four years prior to death (median 60 days). Children with haematological malignancies were treated with a curative intent closer to death and were also given chemotherapy (RR 5.5; 1.3–22.9), transfusions (RR 2.0; 1.0–4.0) and antibiotics (RR 5.3; 1.8–15.5) more frequently than children with brain tumours the last weeks of life.
The majority of children dying from a malignancy were treated with noncurative intent at the time of death. The timing of a transition in care varied with the diagnoses, being closer to death in children with haematological malignancies.