ArticleJournal of intensive care2022
Intensive care unit versus high-dependency care unit admission on mortality in patients with septic shock: a retrospective cohort study using Japanese claims data.
Article in Journal of intensive care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 28 citations in OpenAlex.
- The Association Between Systemic Inflammatory and Metabolic Indices and Early Adverse Clinical Outcomes in Adult Patients Admitted to the Post-anaesthesia Care Unit: A Retrospective Observational Study.Turkish journal of anaesthesiology and reanimation · 2026Article
- Developing consensus-based indicators for intensive care unit capacity and capability in South Korea: a modified Delphi study.Acute and critical care · 2026Article
- Sequential Versus Non-Sequential Polymyxin B Hemoperfusion in Severe Sepsis and Septic Shock: A Real-World Cohort Analysis of Survival in an Asian ICU.Diagnostics (Basel, Switzerland) · 2026Article
- Relationship between volatile anesthetics and functional outcomes in patients with subarachnoid hemorrhage.Journal of anesthesia, analgesia and critical care · 2025Article
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024.Journal of intensive care · 2025Article
- In-hospital mortality of patients admitted to the intermediate care unit in hospitals with and without an intensive care unit: a nationwide inpatient database study.Critical care (London, England) · 2025Article
- Article
- The Role of Intermediate Care in Supporting Critically Ill Patients and Critical Care Infrastructure.Critical care clinics · 2024Review
- Case volume and specialization in critically ill emergency patients: a nationwide cohort study in Japanese ICUs.Journal of intensive care · 2024Article
- Article
- Intensive care unit mortality and cost-effectiveness associated with intensivist staffing: a Japanese nationwide observational study.Journal of intensive care · 2023Article
- Intensive care unit versus high-dependency care unit admission on mortality in patients with septic shock: let's think to the survival chain concept for septic shock.Journal of intensive care · 2022Article
- Correction: Intensive care unit versus high-dependency care unit admission on mortality in patients with septic shock: a retrospective cohort study using Japanese claims data.Journal of intensive care · 2022Article
- The Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024.Acute medicine & surgeryArticle
- Epidemiology of sepsis in a Japanese administrative database.Acute medicine & surgeryReview
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSeptic shock is a common and life-threatening condition that requires intensive care. Intensive care units (ICUs) in Japan are classified into ICUs and high-dependency care units (HDUs), depending on presence of full-time certified intensivists and the number of assigned nurses. Compared with other developed countries, there are fewer intensive care beds and certified intensivists in Japan; therefore, non-intensivists often treat patients with septic shock in HDUs. It is unknown where we should treat patients with septic shock because no studies have compared the clinical outcomes between ICU and HDU treatment. This study aimed to elucidate which units should admit patients with septic shock by comparing mortality data and resource use between ICU and HDU admissions.
methodsIn this retrospective cohort study, we used a nationwide Japanese administrative database to identify adult patients with septic shock who were admitted to ICUs or HDUs between January 2010 and February 2021. The patients were divided into two groups, based on admittance to ICU or HDU on the day of hospitalization. The primary outcome was 30-day all-cause mortality adjusted for covariates using Cox regression analyses; the secondary outcomes were the length of ICU or HDU stay and length of hospital stay.
resultsOf the 10,818 eligible hospitalizations for septic shock, 6584 were in the ICU group, and 4234 were in the HDU group. Cox regression analyses revealed that patients admitted to the ICUs had lower 30-day mortality (adjusted hazard ratio: 0.89; 95% confidence interval: 0.83-0.96; P = 0.005). Linear regression analyses showed no significant difference in hospital length of stay or ICU or HDU length of stay.
conclusionsAn association was observed between ICU admission and lower 30-day mortality in patients with septic shock. These findings could provide essential insights for building a more appropriate treatment system.
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