{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T01:56:19Z","timestamp":1788314179952,"version":"build-2803163510"},"reference-count":65,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2019,3,26]],"date-time":"2019-03-26T00:00:00Z","timestamp":1553558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Efforts to improve the quality of end\u2010of\u2010life (EOL) care depend on better knowledge of the care that children, adolescents, and young adults with cancer receive, including high\u2010intensity EOL (HI\u2010EOL) care. The objective was to assess the rates of HI\u2010EOL care in this population and to determine patient\u2010 and hospital\u2010related predictors of HI\u2010EOL from the French national hospital database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a population\u2010based, retrospective study of a cohort of patients aged 0 to 25\u00a0years at the time of death who died at hospital as a result of cancer in France between 2014 and 2016. The primary outcome was HI\u2010EOL care, defined as the occurrence of \u22651 chemotherapy session &lt;14\u00a0days from death, receiving care in an intensive care unit \u22651 time, &gt;1 emergency room admission, and &gt;1 hospitalization in an acute care unit in the last 30\u00a0days of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study included 1899 individuals from 345 hospitals; 61.4% experienced HI\u2010EOL care. HI\u2010EOL was increased with social disadvantage (adjusted odds ratio [AOR], 1.30; 95% confidence interval [CI], 1.03\u20101.65;\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\u00a0.028), hematological malignancies (AOR, 2.09; 95% CI, 1.57\u20102.77;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001), complex chronic conditions (AOR, 1.60; 95% CI, 1.23\u20102.09;\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\u00a0.001) and care delivered in a specialty center (AOR, 1.70; 95% CI, 1.22\u20102.36;\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\u00a0.001). HI\u2010EOL was reduced in cases of palliative care (AOR, 0.31; 95% CI, 0.24\u20100.41;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A majority of children, adolescents, and young adults experience HI\u2010EOL care. Several features (eg, social disadvantage, cancer diagnosis, complex chronic conditions, and specialty center care) were associated with HI\u2010EOL care. These findings should now be discussed with patients, families, and professionals to define the optimal EOL.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cncr.32035","type":"journal-article","created":{"date-parts":[[2019,3,26]],"date-time":"2019-03-26T19:25:25Z","timestamp":1553628325000},"page":"2300-2308","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["High\u2010intensity end\u2010of\u2010life care among children, adolescents, and young adults with cancer who die in the hospital: A population\u2010based study from the French national hospital database"],"prefix":"10.1002","volume":"125","author":[{"given":"Gabriel","family":"Revon\u2010Rivi\u00e8re","sequence":"first","affiliation":[{"name":"Department of Pediatric Hematology and Oncology La Timone Children\u2019s Hospital, APHM Marseille France"},{"name":"F\u00e9d\u00e9ration des \u00c9quipes Ressources R\u00e9gionales de Soins Palliatifs P\u00e9diatriques"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Pauly","sequence":"additional","affiliation":[{"name":"Aix\u2010Marseille University, EA 3279 CEReSS \u2010 Health Service Research and Quality of Life Center Marseille France"},{"name":"Department of Medical Information APHM Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karine","family":"Baumstarck","sequence":"additional","affiliation":[{"name":"Aix\u2010Marseille University, EA 3279 CEReSS \u2010 Health Service Research and Quality of Life Center Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile","family":"Bernard","sequence":"additional","affiliation":[{"name":"Aix\u2010Marseille University, EA 3279 CEReSS \u2010 Health Service Research and Quality of Life Center Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Andr\u00e9","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology La Timone Children\u2019s Hospital, APHM Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Claude","family":"Gentet","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology La Timone Children\u2019s Hospital, APHM Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Seyler","sequence":"additional","affiliation":[{"name":"Department of Medical Information APHM Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Fond","sequence":"additional","affiliation":[{"name":"Aix\u2010Marseille University, EA 3279 CEReSS \u2010 Health Service Research and Quality of Life Center Marseille France"},{"name":"Department of Medical Information APHM Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Orleans","sequence":"additional","affiliation":[{"name":"Department of Medical Information APHM Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e9rard","family":"Michel","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology La Timone Children\u2019s Hospital, APHM Marseille France"},{"name":"Aix\u2010Marseille University, EA 3279 CEReSS \u2010 Health Service Research and Quality of Life Center Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Auquier","sequence":"additional","affiliation":[{"name":"Aix\u2010Marseille University, EA 3279 CEReSS \u2010 Health Service Research and Quality of Life Center Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1229-6622","authenticated-orcid":false,"given":"Laurent","family":"Boyer","sequence":"additional","affiliation":[{"name":"Aix\u2010Marseille University, EA 3279 CEReSS \u2010 Health Service Research and Quality of Life Center Marseille France"},{"name":"Department of Medical Information APHM Marseille France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,3,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.11.042"},{"key":"e_1_2_8_3_1","unstructured":"Centers for Disease Control and Prevention.Ten leading causes of death and injury.2013.www.cdc.gov\/injury\/wisqars\/leadingcauses.html. 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