As P < 0.05. Results There were 168 female (68.9 ) and 75 male (30.7 ) patients. The mean age of the study population and the APACHE II score were 89.55 ?3.61 years and 17.98 ?6.3, respectively. Median ventilation-days and length of stay were 6 and 8.14 days, respectively. Tracheotomy was performed in 44.1 , dialysis therapy in 15.2 and hemodynamic monitoring in 19.8 . Only the group above 95 years old had a significant increase of days of ventilation and length of stay: 18.77 vs 10.47 days (P = 0.01) and 19.74 vs 12.86 days (P = 0.07), respectively. The predicted APACHE II mortality for the studied population was 26.9 ?17.21 and the present rate to the population studied was 47.7 . Patients in dialysis and with diagnosis of sepsis at admission had poorer prognosis (respectively a 1.6 and 1.52 times likely ratio to die).P483 Abstract withdrawn P484 Causes and consequences of failure of implementation of management plans in critical careM El Toukhy, P McQuillan Portsmouth Hospital PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20799856 NHS Trust, Portsmouth, UK Critical Care 2007, 11(Suppl 2):P484 (doi: 10.1186/cc5644) Introduction We investigated patient management plans to ascertain the total number made, types of plan, priority, personnel responsible and expected time frame, proportion completed and the causes and consequences of failed plans (on the patient, the family and the critical care service). Methods Over seven consecutive days, details of all consultant determined management plans were recorded by a dedicated nurse auditor. A plan was defined as an identifiable do-able, shortterm action. Data on type, (arbitrary) priority, involved personnel and time frame were noted. The auditor later returned at the end of shift to determine whether plans had been completed in the appropriate time frame (successful plan) or not (unsuccessful plan). For unsuccessful plans, the nurse, senior nurse, senior house officer, fellow and consultant were all independently quizzed on causes and consequences (for patient, family, service) from a predetermined list of possibilities. Results Of 200 plans, 130 were successful, for three plans data were missing and 67 (34 ) plans were unsuccessful. OfSAvailable online http://ccforum.com/supplements/11/SConclusion The percentage of older patients admitted to the ICU is increasing. The need for tracheotomy and dialysis as well as the length of stay are increasing with this population. APACHE scores do not seem to present a good relationship with mortality in this population. Dialysis and sepsis were associated with a significant increase in mortality.P486 TP-3654 web Outcome of octogenarians versus nonoctogenarians admitted to the intensive care unit with return of spontaneous circulation after out-of-hospital cardiac arrestI van Stijn, R Bosman, H Oudemans-van Straaten, P van der Voort, J Wester, D Zandstra, J van der Spoel OLVG, Amsterdam, The Netherlands Critical Care 2007, 11(Suppl 2):P486 (doi: 10.1186/cc5646) Introduction The aim of this study was to evaluate the outcome of octogenarians (O, age >79 years) versus nonoctogenarians (NO, age <80 years) in relation to predicted outcome (APACHE II predicted mortality, AIIPM) and length of stay in the ICU in days (LOS) after out-of-hospital cardiac arrest (OHCA). Methods From 1 January 1997 to 1 December 2006, the AIIPM, LOS and hospital mortality were prospectively recorded and the standardised mortality ratio (SMR) was calculated. Patients were categorised in cohorts of AIIPM. Results Hospital mortality in the NO group.