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Background <p>Research evaluating the impact of pediatric palliative care (PPC) consultation on care utilization in the NICU is limited.</p> Objectives <p>Describe the impact of PPC on care utilization during admission and end-of-life (EOL).</p> Methods <p>Retrospective review of infants who died in a level IV NICU (2014–2024). Mann–Whitney U, Chi-square, and Fisher’s exact tests and regression analysis were used to evaluate associations between PPC and medical intensity.</p> Results <p>65/127 (51.2%) infants received PPC. Infants with PPC had significantly longer lengths of stay (LOS), more subspecialty consultations, more do-not-resuscitate orders (DNR), fewer codes, and differences in mode of death. In regression analyses, PPC predicted higher odds of DNR orders, fewer EOL ICU/surgical interventions and codes at EOL.</p> Conclusion <p>PPC is associated with longer LOS and more subspecialists throughout admission but lower medical intensity at EOL. Different measures of care utilization may reflect dynamic interactions between PPC consultants and medically complex infants over time.</p>

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Impact of palliative care consultation on neonatal end-of-life care utilization

  • 期刊论文

  • 发表日期：

    2026年7月14日

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  • Matthew Lin,
  • Olivia Bosworth,
  • Sadaf Kazmi,
  • Taylor Kiernan,
  • Clara Horner,
  • Jordan Nelson,
  • Kristyn Pierce,
  • Deborah Dore,
  • Daniel Eison,
  • Christine Zawistowski

摘要

Background

Research evaluating the impact of pediatric palliative care (PPC) consultation on care utilization in the NICU is limited.

Objectives

Describe the impact of PPC on care utilization during admission and end-of-life (EOL).

Methods

Retrospective review of infants who died in a level IV NICU (2014–2024). Mann–Whitney U, Chi-square, and Fisher’s exact tests and regression analysis were used to evaluate associations between PPC and medical intensity.

Results

65/127 (51.2%) infants received PPC. Infants with PPC had significantly longer lengths of stay (LOS), more subspecialty consultations, more do-not-resuscitate orders (DNR), fewer codes, and differences in mode of death. In regression analyses, PPC predicted higher odds of DNR orders, fewer EOL ICU/surgical interventions and codes at EOL.

Conclusion

PPC is associated with longer LOS and more subspecialists throughout admission but lower medical intensity at EOL. Different measures of care utilization may reflect dynamic interactions between PPC consultants and medically complex infants over time.