Describing Deaths over a Decade: The Final Week of Life Among Hospitalized Children with Cancer
Abstract
1. Introduction
2. Materials and Methods
2.1. Population
2.2. Data Extraction
2.3. Statistical Analysis
3. Results
3.1. Medical Interventions
3.2. Chemotherapy
3.3. CPR
3.4. Location
3.5. Cause of Death
4. Discussion
4.1. Use of Chemotherapy in Final Days
4.2. CPR Cohort Considerations
4.3. Location of Death—Intensive Care or Inpatient Floor
4.4. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
| CPR | Cardiopulmonary Resuscitation |
| DNR | Do Not Resuscitate |
| ICU | Intensive Care Unit |
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| Variable | Result |
|---|---|
| 0–7 years | 126 (36.63%) |
| 8–13 years | 79 (22.97%) |
| 14–18 years | 72 (20.93%) |
| >18 years | 67 (19.48%) |
| Gender | |
| Male | 205 (59.6%) |
| Female | 139 (40.4%) |
| Race | |
| White | 223 (67.5%) |
| Black/African American | 85 (24.6%) |
| Other | 14 (4.1%) |
| Asian | 6 (1.7%) |
| Unknown | 1 (0.3%) |
| Ethnicity | |
| Non-Hispanic | 267 (77.6%) |
| Hispanic/Latino | 70 (20.3%) |
| Unknown | 7 (2%) |
| Religion | |
| Christian | 270 (78.5%) |
| Unknown/Unaffiliated | 60 (17.4%) |
| Muslim | 6 (1.7%) |
| Amish | 3 (0.9%) |
| Hindu | 2 (0.6%) |
| Other | 2 (0.6%) |
| Jewish | 1 (0.3%) |
| Location | |
| ICU | 174 (50.6%) |
| Inpatient Unit | 170 (49.4%) |
| Interpreter Services | |
| No | 286 (83.1%) |
| Yes | 58 (16.9%) |
| Decision Maker | |
| Both parents | 190 (55.2%) |
| Mom | 84 (24.4%) |
| Self with Parent Actively (loss of capacity) | 32 (9.3%) |
| Other | 16 (4.7%) |
| Dad | 10 (2.9%) |
| Self | 12 (3.5%) |
| Primary Cancer Diagnosis | |
| Hematologic malignancies | 172 (50.0%) |
| Solid Tumor | 99 (28.8%) |
| Brain Tumor | 56 (16.3%) |
| Bone Marrow Transplant | 17 (4.9%) |
| Ever in PICU | |
| Yes | 280 (81.4%) |
| No | 64 (18.6%) |
| Previous Resuscitation (Code Blue Event) | |
| No | 275 (79.9%) |
| Yes | 69 (20.1%) |
| Bone Marrow Transplant History | |
| No | 179 (52.0%) |
| Yes (allogeneic) | 142 (41.3%) |
| Yes (autologous) | 23 (6.7%) |
| Evidence of Disease 7 days before death | |
| Yes | 294 (85.5%) |
| No | 50 (14.5%) |
| Variable | 7 Days Before Death | 48 h Before Death | 24 h Before Death |
|---|---|---|---|
| Interventions the week before death | |||
| PICU Setting | |||
| Yes | 131 (38.1%) | 156 (45.3%) | 176 (51.2%) |
| No | 213 (61.9%) | 188 (54.7%) | 168 (48.8%) |
| CPR | |||
| Yes | 1 (0.3%) | 1 (0.3%) | 55 (16%) |
| No | 343 (99.7%) | 343 (99.7%) | 289 (84%) |
| Pressor Use | |||
| New | 22 (6.4%) | 15 (4.4%) | 34 (9.9%) |
| Continued | 28 (8.1%) | 48 (14%) | 53 (15.4%) |
| Discontinued | 12 (3.5%) | 4 (1.2%) | 10 (2.9%) |
| None * | 282 (82%) | 277 (80.5%) | 247 (71.8%) |
| Ventilator Use | |||
| New | 22 (6.4%) | 10 (2.9%) | 22 (6.4%) |
| Continued | 84 (24.4%) | 106 (30.8%) | 96 (27.9%) |
| Discontinued | 8 (2.3%) | 0 (0%) | 21 (6.1%) |
| None * | 230 (66.9%) | 228 (66.3%) | 205 (59.6%) |
| Dialysis | |||
| New | 15 (4.4%) | 4 (1.2%) | 3 (0.9%) |
| Continued | 41 (11.9%) | 46 (13.4%) | 34 (9.9%) |
| Discontinued | 4 (1.2%) | 7 (2%) | 19 (5.5%) |
| None * | 284 (82.6%) | 287 (83.4%) | 288 (83.7%) |
| Antibiotics or antifungals | |||
| New | 18 (5.2%) | 4 (1.2%) | 1 (0.3%) |
| Continued | 254 (73.8%) | 252 (73.3%) | 230 (66.9%) |
| Discontinued | 19 (5.5%) | 16 (4.7%) | 27 (7.8%) |
| None * | 53 (15.4%) | 72 (20.9%) | 86 (25%) |
| Artificial Nutrition and Hydration | |||
| New | 39 (11.3%) | 12 (3.5%) | 8 (2.3%) |
| Continued | 241 (70.1%) | 267 (77.6%) | 258 (75%) |
| Discontinued | 7 (2%) | 9 (2.6%) | 23 (6.7%) |
| None * | 57 (16.6%) | 56 (16.3%) | 55 (16%) |
| Disease-Directed Chemotherapy | |||
| New | 8 (2.3%) | 4 (1.2%) | 0 (0%) |
| Continued | 51 (14.8%) | 45 (13.1%) | 33 (9.6%) |
| Discontinued | 20 (5.8%) | 10 (2.9%) | 17 (4.9%) |
| None * | 265 (77%) | 285 (82.8%) | 294 (85.5%) |
| Palliative Chemotherapy | |||
| Unknown | 0 (0%) | 4 (8.2%) | 2 (6.1%) |
| Yes | 19 (32.8%) | 17 (34.7%) | 15 (45.5%) |
| No | 39 (67.2%) | 28 (57.1%) | 16 (48.5%) |
| Chest Tube | |||
| New | 9 (2.6%) | 3 (0.9%) | 1 (0.3%) |
| Continued | 20 (5.8%) | 29 (8.5%) | 27 (7.8%) |
| Discontinued | 1 (0.3%) | 0 (0%) | 3 (0.9%) |
| None * | 314 (91.3%) | 311 (90.7%) | 313 (91%) |
| Peritoneal Drain | |||
| New | 2 (0.6%) | 2 (0.6%) | 2 (0.6%) |
| Continued | 8 (2.3%) | 11 (3.2%) | 11 (3.2%) |
| Discontinued | 1 (0.3%) | 0 (0%) | 0 (0%) |
| None * | 333 (96.8%) | 331 (96.2%) | 331 (96.2%) |
| Surgery | |||
| Unknown/Missing | 0 (0%) | 0 (0%) | 1 (0.3%) |
| Yes | 16 (4.7%) | 4 (1.2%) | 8 (2.3%) |
| No | 328 (95.3%) | 340 (98.8%) | 335 (97.4%) |
| No CPR (N = 266, 89.3%) | Yes CPR (N = 32, 10.7%) | p-Value | |
|---|---|---|---|
| Age | 0.0108 1 | ||
| Mean (SD) | 10.7 (6.62) | 7.56 (7.65) | |
| Diagnosis | |||
| Leukemia | 121 (45.5%) | 22 (68.8%) | 0.037 2 |
| Solid Tumor | 91 (34.2%) | 8 (25.0%) | |
| Brain Tumor | 54 (20.3%) | 2 (6.3%) |
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Share and Cite
Weaver, M.S.; Liang, J.; Kaye, E.C.; Levine, D.A.; Li, C.; Heifner, A.; Gabela, A.; Johnson, L.-M. Describing Deaths over a Decade: The Final Week of Life Among Hospitalized Children with Cancer. Children 2026, 13, 218. https://doi.org/10.3390/children13020218
Weaver MS, Liang J, Kaye EC, Levine DA, Li C, Heifner A, Gabela A, Johnson L-M. Describing Deaths over a Decade: The Final Week of Life Among Hospitalized Children with Cancer. Children. 2026; 13(2):218. https://doi.org/10.3390/children13020218
Chicago/Turabian StyleWeaver, Meaghann S., Jia Liang, Erica C. Kaye, Deena A. Levine, Cai Li, Andrea Heifner, Alejandra Gabela, and Liza-Marie Johnson. 2026. "Describing Deaths over a Decade: The Final Week of Life Among Hospitalized Children with Cancer" Children 13, no. 2: 218. https://doi.org/10.3390/children13020218
APA StyleWeaver, M. S., Liang, J., Kaye, E. C., Levine, D. A., Li, C., Heifner, A., Gabela, A., & Johnson, L.-M. (2026). Describing Deaths over a Decade: The Final Week of Life Among Hospitalized Children with Cancer. Children, 13(2), 218. https://doi.org/10.3390/children13020218

