INTRODUCTION The paper presents important facts in the application of recombinant human factor VIIa (rFVIIa) and in the treatment of renal cell carcer. CASE REPORT A 69-year old male with infiltrative renal cell carcer underwent radical nephrectomy using Hasagawa's approach. The extirpated tumor was 35 cm in diameter. During surgery, the patient suffered cardiac arrest with 3500 ml blood loss. Twenty-four hours after operation, he lost additional 2100 ml of blood. Despite adequate blood substitution with intensive surgical attempts to treat haemostasis, bleeding did not stop until the application of rFVIIa (300 IU). The patient survived and fully recovered. CONCLUSION To control massive non-surgical bleeding additionally complicated by paraneoplastic syndrome, extensive surgical intervention, haemodilution and massive blood substitution, the application of rFVIIa has proved to be most successful.

Aims: Evidence suggests patients from CALD backgrounds may have poorer health outcomes, due to a complex interplay of factors. We aimed to investigate inhospital outcomes for such patients admitted to our new Aged Care Rapid Investigation and Assessment (ARIA) unit. Methods: ARIA heralds a new development within our tertiary hospital, comprising a specialised multidisciplinary team casefinding older patients for admission to a rapidaccess geriatric unit. We prospectively included all such patients admitted to ARIA over a 14 month period and investigated whether CALD status was associated with hospital length of stay (LOS), ED LOS, new RACF admission, inhospital death, or 90day representation. Results: In total, 58% (107/185) patients were from CALD backgrounds, most commonly Italy (22), China (10) and Vietnam (8). Twothirds (69/107) patients were classified as nonEnglish speaking (NES; insufficient English to communicate their history). Compared to nonCALD patients, patients from CALD background were frailer (mean premorbid CSHA score 5.86 versus 5.59, P = 0.03); no differences were seen in terms of age (P = 0.35), sex (P = 0.19) or Charlson comorbidity index (P = 0.11). On multivariable analysis, adjusting for age, delirium, dementia and RACF residence, those from CALD background had a longer ED LOS (adjusted regression coefficient 2.59, P = 0.048; 9 versus 7 hours). CALD background was not associated with other markers of poor outcome. NES status alone was not associated with outcomes assessed. Conclusions: In this cohort of older inpatients, CALD status was not associated with poorer outcomes. Further research might focus on patient and provider factors influencing possible improvements in care and outcomes for these patients. POSTER PRESENTATIONS