Evidence map›Paper›PMID 36495233›Full record

ArticleJournal of paediatrics and child health2023

End-of-life care over four decades in a quaternary neonatal intensive care unit.

Alexandra Barry, Trisha Prentice, Dominic Wilkinson

Open access · hybridAbstract read
In one paragraph

Article in Journal of paediatrics and child health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.8field-weighted citation impact, top 27% of its field
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, 6 citations in OpenAlex.

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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

3 authors at 2 institutions in 2 countries.

Alexandra BarryNeonatal Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.ORCID 0000-0003-3547-1526
Trisha PrenticeNeonatal Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.ORCID 0000-0003-4271-7950
Dominic WilkinsonMurdoch Children's Research Institute, Melbourne, Victoria, Australia.ORCID 0000-0003-3958-8633
Royal Children's Hospital · AUJohn Radcliffe Hospital · GB

Funding

Wellcome TrustWellcome Trust 203132/Z/16/Z
6 · The paper itself

Abstract

aimDeath in the neonatal intensive care unit (NICU) commonly follows a decision to withdraw or limit life-sustaining treatment. Advances in medicine have changed the nature of life-sustaining interventions available and the potential prognosis for many newborn conditions. We aimed to assess changes in causes of death and end-of-life care over nearly four decades.

methodsA retrospective review of infants dying in the NICU was performed (2017-2020) and compared with previous audits performed in the same centre (1985-1987 and 1999-2001). Diagnoses at death were recorded for each infant as well as their apparent prognosis and any withdrawal or limitations of medical treatment.

resultsIn the recent epoch, there were 88 deaths out of 2084 admissions (4.2%), a reduction from the previous epochs (132/1362 (9.7%) and 111/1776 (6.2%), respectively, for epochs 1 and 2). More than 90% of infants died after withdrawal of life-sustaining treatment, an increase from the previous two epochs (75%). There was a reduction in deaths from chromosomal abnormalities, complications related to prematurity and severe birth asphyxia.

conclusionsThere continue to be changes in both the diagnoses leading to death and approaches to withdrawal of treatment in the NICU. These may reflect ongoing changes in both prenatal and post-natal diagnostics as well as changing attitudes towards palliative care within the medical and wider community.

Indexed as

Intensive Care Units, NeonatalTerminal CareFemaleHumansInfantInfant, NewbornInfant, PrematurePalliative CarePregnancyRetrospective Studies

Identifiers

PMID36495233
PMCPMC10107744
OpenAlexW4311024327

What OpenQuestion holds

Textmetadata
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 OpenQuestion graph.