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Mortality After PICU Care: Place Of Death And Impact Of Limitation Of Medical Treatment

Kalzén, Håkan ; Larsson, B. ; Lindberg, Lars LU orcid ; Ingemansson, Ola ; Frostell, Claes and Eksborg, Staffan (2023) In Jornal of community medicine and public health reports 4(11).
Abstract (Swedish)
Abstract
Aim: This study sought to investigate the hypothesis that children dying outside a pediatric intensive care unit (PICU) after PICU discharge have a limitation of medical treatment (LOMT) order in place, limiting PICU readmission at the time of death.
Methods: A cohort was identified of all children (n=3890; 5019 admissions) treated in a PICU in Sweden over 3 consecutive years between January 1, 2008, and December 31, 2010. Survival was determined up to 4 years post-PICU discharge. For the 268 children who died during the study period, notes were checked for demographic data, LOMT, and place of death in a PICU, in a hospital ward, or at home.
Results: For 252 (94%) of the 268 deceased children, place of death and LOMT... (More)
Abstract
Aim: This study sought to investigate the hypothesis that children dying outside a pediatric intensive care unit (PICU) after PICU discharge have a limitation of medical treatment (LOMT) order in place, limiting PICU readmission at the time of death.
Methods: A cohort was identified of all children (n=3890; 5019 admissions) treated in a PICU in Sweden over 3 consecutive years between January 1, 2008, and December 31, 2010. Survival was determined up to 4 years post-PICU discharge. For the 268 children who died during the study period, notes were checked for demographic data, LOMT, and place of death in a PICU, in a hospital ward, or at home.
Results: For 252 (94%) of the 268 deceased children, place of death and LOMT status (yes/no) for readmission to PICU care were identified. For 107 of those 252 studied (42%), the place of death was outside a PICU (in hospital or at home). For 80 (75%) of these 107 children, a written LOMT in the patient notes stating "no readmission to PICU care" was recorded. Home as the place of death was found for 36 of the 107 children (34%). For 27 (75%) of these 36 children, a written LOMT in the patient notes stating "no readmission to PICU care" was recorded.
Conclusion: In this study, we found that most children (75%) who died outside a PICU setting (in a hospital or at home) after PICU discharge had a LOMT recorded limiting their readmission to a PICU.
Keywords: PICU, mortality, prognosis, limitation of medical treatment, child, ethics (Less)
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author
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publishing date
type
Contribution to journal
publication status
published
subject
in
Jornal of community medicine and public health reports
volume
4
issue
11
ISSN
2692-9899
DOI
10.38207/JCMPHR/2023DEC041205156
language
English
LU publication?
no
id
e49eabe7-fe51-416b-bea1-ea970e74ebfb
date added to LUP
2026-01-08 21:25:37
date last changed
2026-01-09 09:43:37
@article{e49eabe7-fe51-416b-bea1-ea970e74ebfb,
  abstract     = {{Abstract<br/>Aim: This study sought to investigate the hypothesis that children dying outside a pediatric intensive care unit (PICU) after PICU discharge have a limitation of medical treatment (LOMT) order in place, limiting PICU readmission at the time of death.<br/>Methods: A cohort was identified of all children (n=3890; 5019 admissions) treated in a PICU in Sweden over 3 consecutive years between January 1, 2008, and December 31, 2010. Survival was determined up to 4 years post-PICU discharge. For the 268 children who died during the study period, notes were checked for demographic data, LOMT, and place of death in a PICU, in a hospital ward, or at home.<br/>Results: For 252 (94%) of the 268 deceased children, place of death and LOMT status (yes/no) for readmission to PICU care were identified. For 107 of those 252 studied (42%), the place of death was outside a PICU (in hospital or at home). For 80 (75%) of these 107 children, a written LOMT in the patient notes stating "no readmission to PICU care" was recorded. Home as the place of death was found for 36 of the 107 children (34%). For 27 (75%) of these 36 children, a written LOMT in the patient notes stating "no readmission to PICU care" was recorded.<br/>Conclusion: In this study, we found that most children (75%) who died outside a PICU setting (in a hospital or at home) after PICU discharge had a LOMT recorded limiting their readmission to a PICU.<br/>Keywords: PICU, mortality, prognosis, limitation of medical treatment, child, ethics}},
  author       = {{Kalzén, Håkan and Larsson, B. and Lindberg, Lars and Ingemansson, Ola and Frostell, Claes and Eksborg, Staffan}},
  issn         = {{2692-9899}},
  language     = {{eng}},
  number       = {{11}},
  series       = {{Jornal of community medicine and public health reports}},
  title        = {{Mortality After PICU Care: Place Of Death And Impact Of Limitation Of Medical Treatment}},
  url          = {{http://dx.doi.org/10.38207/JCMPHR/2023DEC041205156}},
  doi          = {{10.38207/JCMPHR/2023DEC041205156}},
  volume       = {{4}},
  year         = {{2023}},
}