Do children die? A retrospective review of deaths in a children's hospital

ABSTRACT

Introduction We present a profile of deaths over two years in the medical departments of a children’s hospital. The findings would help us better understand the individual dying experience of these patients. Service gaps and ways tooptimise provision of supportive care were identified in the process.

Methods The inpatient notes of all children who died in the medical wards, including intensive care unit, were traced and reviewed by the investigators. Demographic data, diagnoses, length of stay and the care received were recorded.

Results A total of 68 children died in the two years. They were representative of all deaths nationally in terms of diagnoses. Two-thirds of the children died in the intensive care unit after having stayed there for an average of five days. All but one patient had invasive ventilation till they died. Eight out of every ten cases were assessed to be actively dying while being cared for. Most had ‘Do-Not-Resuscitate’ status in place, but few had been offered the option to choose the place of care or death when it became clear that they would not survive.

Conclusion More efforts could be made to improve the care of dying children and their families. The Paediatric Palliative Service could assist in advance care planning at the end of life.

 

Keywords: advance care planning, child, death, hospitals, palliative care
Singapore Med J 2012; 53(3): 192–195