Palliative Care Team, Department of Oncology, Aarhus University Hospital, Palle Juul Jensens Blvd. 99, 8200, Aarhus N, Denmark.
Department of Clinical Epidemiology, Aarhus University and Aarhus University Hospital, Olof Palmes Allé 43-45, 8200, Aarhus N, Denmark.
Eur J Pediatr. 2020 Aug;179(8):1227-1238. doi: 10.1007/s00431-020-03689-2. Epub 2020 Jun 30.
Through a systematic review and meta-analyses, we aimed to determine predictors for place of death among children. We searched online databases for studies published between 2008 and 2019 comprising original quantitative data on predictors for place of death among children. Data regarding study design, population characteristics and results were extracted from each study. Meta-analyses were conducted using generic inverse variance method with random effects. Fourteen cohort studies met the inclusion criteria, comprising data on 106,788 decedents. Proportions of home death varied between countries and regions from 7% to 45%. Lower age was associated with higher odds of hospital death in eight studies (meta-analysis was not possible). Children categorised as non-white were less likely to die at home compared to white (pooled OR 0.6; 95% CI 0.5-0.7) as were children of low socio-economic position versus high (pooled OR 0.7; 95% CI 0.6-0.9). Compared to patients with cancer, children with non-cancer diagnoses had lower odds of home death (pooled OR 0.5; 95% CI 0.5-0.5).Conclusion: Country and region of residence, older age of the child, high socio-economic position, 'white' ethnicity and cancer diagnoses appear to be independent predictors of home death among children. What is Known: • Home is often considered an indicator of quality in end-of-life care. • Most terminally ill children die in hospitals. What is New: • Through a systematic review and meta-analyses, this study examined predictors for place of death among children. • Country and region of residence, older age of the child, high socio-economic position, white ethnicity and having a cancer diagnosis appear to be independent predictors of home death among terminally ill children.
通过系统评价和荟萃分析，我们旨在确定儿童死亡地点的预测因素。我们在在线数据库中搜索了 2008 年至 2019 年期间发表的研究，这些研究包含了儿童死亡地点预测因素的原始定量数据。从每项研究中提取有关研究设计、人口特征和结果的数据。使用随机效应的通用倒数方差法进行荟萃分析。14 项队列研究符合纳入标准，包括 106788 名死者的数据。各国和各地区的居家死亡比例从 7%到 45%不等。有八项研究表明，年龄较小与医院死亡的几率较高相关（无法进行荟萃分析）。与白人相比，非白种儿童（合并 OR 0.6；95%CI 0.5-0.7）和社会经济地位较低的儿童（合并 OR 0.7；95%CI 0.6-0.9）更不可能在家中死亡。与癌症患者相比，非癌症诊断的儿童在家中死亡的几率较低（合并 OR 0.5；95%CI 0.5-0.5）。结论：居住国家和地区、儿童年龄较大、社会经济地位较高、“白人”种族和癌症诊断似乎是儿童在家中死亡的独立预测因素。已知情况：• 家庭通常被认为是临终关怀质量的指标。• 大多数绝症儿童死于医院。新内容：• 通过系统评价和荟萃分析，本研究探讨了儿童死亡地点的预测因素。• 居住国家和地区、儿童年龄较大、社会经济地位较高、白人种族和癌症诊断似乎是绝症儿童在家中死亡的独立预测因素。
