Of 1.0 or more was used as a cut-off to identify patients with a relevant

Of 1.0 or more was used as a cut-off to identify patients with a relevant deterioration of HRQOL at follow-up. Results: Mean age of the study TCN238 cost cohort (n = 318) was 57 ?17 (?SD) years, median 59; 58 were male. Mean ICU length of stay was 11 ?19 days, median 4.5. Mean APACHE II score after 24 hours was 18 ?10, mean TISS score was 33 ?14. One hundred and seventy patients (53 ) had MOD with a mean SOFA TMS of 11.8 ?4. Cumulative mortality rates for non-MOD/MOD patients were 3 /45 in the ICU, 6 /57 in the hospital, and 12 /64 at 6 month follow-up. At follow-up HRQOL data could be obtained in 118 non-MOD and 53 PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20726384 MOD patients, 19 patients were lost to follow-up. Compared with normative population data pre-ICU HRQOL was significantly (P < 0.0005) impaired in all ICU patients. MOD patients demonstrated more severe deteriorated pre-ICU physical health scores than non-MOD patients (P < 0.0005), whereas mental health domains did not differ between the two groups (P = 0.61). Survivors of MOD showed further deteriorated physical health scores at follow-up (P = 0.002) but unchanged mental health (P = 0.51). Non-MOD patients demonstrated unchanged or even improved scores in all eight SF-36 domains. The majority of the survivors (94 ) were living at home. Ninety-one percent of those previously in employment had returned to their former work. Conclusion: Using age and gender matched population norms MOD patients demonstrated more severe impaired pre-ICU physical health scores than non-MOD patients. At follow-up a deterioration in most areas of physical health was noted in MOD but not in non-MOD patients, whereas domains of mental health did not differ between the two groups. The SF-36 seems to have sufficient discriminative validity when used to measure HRQOL in survivors of MOD. Reference:1. Heyland DK, et al.: Crit Care Med 2000, 28:3599-3605.P251 Are clinical diagnoses prior to death reliable in critically ill patients?GD Perkins, S Davies, DF McAuley, F Gao Department of Intensive Care Medicine, Birmingham Heartlands Hospital, Birmingham B9 5SS, UK Background: European and American studies have recently highlighted discrepancies between clinical diagnoses and post mortem findings in patients who died on the intensive care unit (ICU). This study set out to determine if similar findings were present in patients that died on an ICU in the UK. Methods: Patients that died between January 1998 and June 2001 were identified from a database of ICU admissions. From this list, patients that had undergone a post mortem were identified and their medical notes reviewed retrospectively to establish the clinical diagnoses prior to death. These were compared to the postAvailable online http://ccforum.com/supplements/6/Smortem cause of death and classified using the Goldman system. This system categorises discrepancies between clinical and post mortem diagnoses into three groups -- major, minor and complete agreement. Major discrepancies were those where the principle, underlying cause of death was missed. Minor were missed diagnoses that may have contributed to death or important diagnoses that were unrelated to the cause of death. Complete agreement indicated concordance between clinical and post mortem diagnoses. Differences between the groups demographics were tested for using repeated measure ANOVA on ranks and chi-squared test. Results: Nine hundred and thirty-nine patients died during the 3.5 year study period, of which 49 (5.2 ) underwent a post mortem exa.