Surgical Interventions During End-of-Life Hospitalizations in Children’s Hospitals

Surgical procedures during pediatric terminal hospitalizations are an essential aspect of end-of-life care. A recent study featuring PISC Senior Scholar Michael Nance, MD, typifies patterns of surgery among pediatric patients during terminal hospitalizations. The study includes 33,693 terminal pediatric hospitalizations. Results indicate that 49.7% of these children underwent surgery during hospitalization. The most common surgeries during terminal hospitalizations involve inserting hardware or catheters (31%). Other common end-of-life surgeries occurred to explore a diagnosis (14%), attempt to rescue a patient from mortality (13%), or obtain a biopsy (13%). The likelihood of surgery during terminal hospitalization decreased as patient ages increased. Additionally, Hispanic children were significantly less likely to undergo surgery during terminal hospitalization. The team concludes that the observations can “reflect different preferences for an access to non-hospital-based, palliative, hospice, and end-of-life care.”

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