Evidence map›Paper›PMID 32787834›Full record

ArticleBMC medical ethics2020

Withdrawal of treatment in a pediatric intensive care unit at a Children's Hospital in China: a 10-year retrospective study.

Huaqing Liu, Dongni Su, Xubei Guo, Yunhong Dai, Xingqiang Dong, Qiujiao Zhu, Zhenjiang Bai, Ying Li, Shuiyan Wu

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medical ethics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. 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

9 authors.

Huaqing LiuHealth Supervision Institute of Gusu District, Suzhou, 215000, Jiangsu, China.
Dongni SuDepartment of Intensive Care Unit, Children's Hospital of Soochow University, No.92, Zhongnan street, Suzhou Industrial Park, Suzhou, Jiangsu, China.
Xubei GuoDepartment of Intensive Care Unit, Children's Hospital of Soochow University, No.92, Zhongnan street, Suzhou Industrial Park, Suzhou, Jiangsu, China.
Yunhong DaiDepartment of Intensive Care Unit, Children's Hospital of Soochow University, No.92, Zhongnan street, Suzhou Industrial Park, Suzhou, Jiangsu, China.
Xingqiang DongDepartment of Intensive Care Unit, Children's Hospital of Soochow University, No.92, Zhongnan street, Suzhou Industrial Park, Suzhou, Jiangsu, China.
Qiujiao ZhuDepartment of Intensive Care Unit, Children's Hospital of Soochow University, No.92, Zhongnan street, Suzhou Industrial Park, Suzhou, Jiangsu, China.
Zhenjiang BaiDepartment of Intensive Care Unit, Children's Hospital of Soochow University, No.92, Zhongnan street, Suzhou Industrial Park, Suzhou, Jiangsu, China.
Ying LiDepartment of Intensive Care Unit, Children's Hospital of Soochow University, No.92, Zhongnan street, Suzhou Industrial Park, Suzhou, Jiangsu, China.
Shuiyan WuDepartment of Intensive Care Unit, Children's Hospital of Soochow University, No.92, Zhongnan street, Suzhou Industrial Park, Suzhou, Jiangsu, China. doctorwu1219@sina.com.ORCID 0000-0002-8963-5082

Funding

Natural Science Fund for colleges and universities of Jiangsu Province 18KJB320022Suzhou Municipal Science and Technology Bureau SYS 201757
6 · The paper itself

Abstract

backgroundPublished data and practice recommendations on end-of-life care generally reflect Western practice frameworks; there are limited data on withdrawal of treatment for children in China.

methodsWithdrawal of treatment for children in the pediatric intensive care unit (PICU) of a regional children's hospital in eastern China from 2006 to 2017 was studied retrospectively. Withdrawal of treatment was categorized as medical withdrawal or premature withdrawal. The guardian's self-reported reasons for abandoning the child's treatment were recorded from 2011.

resultsThe incidence of withdrawal of treatment for children in the PICU decreased significantly; for premature withdrawal the 3-year average of 15.1% in 2006-2008 decreased to 1.9% in 2015-2017 (87.4% reduction). The overall incidence of withdrawal of care reduced over the time period, and withdrawal of therapy by guardians was the main contributor to the overall reduction. The median age of children for whom treatment was withdrawn increased from 14.5 months (interquartile range: 4.0-72.0) in 2006 to 40.5 months (interquartile range: 8.0-99.0) in 2017. Among the reasons given by guardians of children whose treatment was withdrawn in 2011-2017, "illness is too severe" ranked first, accounting for 66.3%, followed by "condition has been improved" (20.9%). Only a few guardians ascribed treatment withdrawal to economic reasons.

conclusionsThe frequency of withdrawal of medical therapy has changed over time in this children's hospital PICU, and parental decision-making has been a large part of the change.

Indexed as

Intensive Care Units, PediatricTerminal CareChildChild, PreschoolChinaHospitals, PediatricHumansInfantRetrospective StudiesChildrenPediatric intensive care unitPremature withdrawalWithdrawing treatment

Identifiers

PMID32787834
PMCPMC7425042

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Registered trials

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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 OpenQuestion graph.