15283-B-Blokker

84 Chapter 5 correct was calculated for each method. Also, the clinically assumed COD, extracted from the clinical data files, was compared to the consensus COD. The performance of PMCT and/ or PMMR in establishing COD was analyzed. The total diagnostic yield, the contribution of MIA and CA for all diagnoses, major diagnoses and GMD, and the percentage of clinically unsuspected diagnoses were calculated. For GMD we also analyzed overlap between MIA, CA and the pre-mortem clinical evaluation. The performance of PMCT and PMMR in establishing CMD, and the added value of the image-guided biopsies was retrospectively analyzed. Inter - observer agreement for major post - mortem diagnoses made on PMCT and PMMR was calculated using Kappa statistic. Role of the Funding source This study was made possible by grants from Erasmus MC Health Care Efficiency (2010-10112), Stichting Coolsingel Rotterdam (255), and Erasmus MC Vriendenfonds (104117). The funding sources had no role in study design, conduct and reporting. RESULTS Recruitment The size of the cohort was mainly determined by the available time for inclusion, i.e. three years. The goal to assemble a substantially larger cohort than in our published pilot of 30 cases(14) was achieved. From January 2012 through December 2014 2197 hospitalized adult patients died, of whom 295 (13.4%) underwent CA; of the latter 99 consecutive cases (33.6%) were included in the study (Appendix F). Among these 61 were men and 38 women. Their mean age was 63 years (range: 25-92). Thirty - one cases were recruited from the General Intensive Care Unit, 15 from the Emergency Room, ten from the Departments of Internal Medicine/Gastroenterology, eight from Oncology, seven from Cardiology/Coronary Care Unit, six from Neurology, five from Thoracic Surgery/Cardiothoracic Intensive Care, five from Hematology, five from Pulmonology, four from General Surgery, and three from Gynecology/Urology. MIA Duration and Tissue Sampling The mean time between death and MIA was 23.2 (SD 15.6) hours. The mean MIA procedure time, including transportation, was 6.28 (SD 1.07) hours. The mean time between MIA and CA was at 9.47 (SD 1.06) hours.