Evidence map›Paper›PMID 38302931›Full record

Observational studyBMC palliative care2024

Children with cancer at the end of life in a middle-income country: integrated pediatric palliative care improves outcomes.

María Isabel Cuervo-Suarez, Daniela Cleves, Natalia Duque-Nieto, Angélica Claros-Hulbert, Karen Molina-Gómez, Jhon Edwar Bolaños-Lopez, María Elena Tello-Cajiao, Justin N Baker, Michael J McNeil, Ximena García-Quintero

Abstract readObservational Study
In one paragraph

Observational study in BMC palliative care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

María Isabel Cuervo-SuarezPalliative Care Department, Fundación Valle del Lili, Avenida Simón Bolívar. Cra. 98 No.18-49, Cali, 760032, Colombia. maria.cuervo@fvl.org.co.
Daniela ClevesDepartment of Global Pediatric Medicine, St. Jude Children's Hospital, Memphis, TN, 38105, USA.
Natalia Duque-NietoDepartment of Pain and Palliative Care, Grupo Keralty, Clinica Sebastian de Belalcazar, Cali, 760044, Colombia.
Angélica Claros-HulbertFaculty of Health Sciences, Universidad de la Sabana, Chia, 250001, Colombia.
Karen Molina-GómezPalliative Care Department, Fundación Valle del Lili, Avenida Simón Bolívar. Cra. 98 No.18-49, Cali, 760032, Colombia.
Jhon Edwar Bolaños-LopezCentro de Biociencias, Seguros SURA Colombia, Medellín, 050021, Colombia.
María Elena Tello-CajiaoFacultad de Ciencias de la Salud, Universidad Icesi, Cali, 760031, Colombia.
Justin N BakerDivision Chief, Quality of Life and Pediatric Palliative, Stanford University School of Medicine, Alto, CA, 94304, USA.
Michael J McNeilDepartment of Global Pediatric Medicine, St. Jude Children's Hospital, Memphis, TN, 38105, USA.
Ximena García-QuinteroDepartment of Global Pediatric Medicine, St. Jude Children's Hospital, Memphis, TN, 38105, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn 2020, the Global Cancer Observatory reported 280,000 cases of childhood cancer worldwide, with a higher burden of disease and mortality rates in low- and middle-income countries. In 2022, the National Institute of Health reported 1708 new cases of childhood cancer in Colombia and an overall survival rate of approximately 55%. The aim of this study is to compare outcomes in children with cancer in the hospital setting during the last 72 h of life who received concurrent Pediatric Palliative Care (PPC) versus oncology care alone.

methodsAn observational descriptive study was conducted between January 2013 and June 2022 in a center for pediatric patients with oncological diagnoses. In 2017, the PPC team was created. Patients between 28 days and 17 years of age who were hospitalized at least 72 h before death were included. A retrospective review of the medical records of patients in the last 72 h of life was performed. Two cohorts were established: oncology-alone group received exclusive management by oncology, and oncology and PPC received concurrent oncology and PPC management since the diagnosis.

resultsWe evaluated 257 medical records of deceased pediatric patients with cancer diagnoses. For the first cohort (2013-2017), 136 patients were included; for the second cohort (2018 and 2022), 121 patients were evaluated. The most frequent diagnosis was leukemia [47.1% (n = 121)]. No significant difference was found in either group between dyspnea, pain, and seizures. Dyspnea was the most frequent symptom in both groups. Agitation and anxiety were reported more frequently in children from the oncology-alone group (22.1% and 13.2%, respectively). The oncology and PPC group received more psychology and social work consultation (94.2% and 70.2% vs. 84.6 and 54.4% in the oncology alone group) and had a higher percentage of advance care planning (79.3% vs. 62.5% in the oncology alone group).

conclusionsThis retrospective study highlights that PPC at the end of life (EoL) offers a holistic approach to the physical and psychosocial symptoms experienced by children with cancer; these patients received more comfort through symptom management and less aggressive treatment at the EoL. The availability of a PPC team may contribute to improvements in the quality of end-of-life care.

trial registrationretrospectively registered.

Indexed as

NeoplasmsTerminal CareChildDeathDyspneaHumansPalliative CareRetrospective StudiesCancer Care UnitsEnd-Of-Life CarePalliative CarePediatrics

Identifiers

PMID38302931
PMCPMC10836057

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.