Case volume and specialization in critically ill emergency patients: a nationwide cohort study in Japanese ICUs.

Jun Fujinaga, Takanao Otake, Takehide Umeda, Toshio Fukuoka

Abstract read

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Article in Journal of intensive care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

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5citing papers in PubMed

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

Intensive care utilization and clinical outcomes after transcatheter aortic valve implantation: a nationwide observational study using the Japanese intensive care patient database.Heart and vessels · 2026
Article
Impact of hospital sepsis case volume on mortality in sepsis patients: a meta-analysis.Frontiers in medicine · 2026
Review
Effect of a generalized early mobilization and rehabilitation protocol on outcomes in trauma patients admitted to the intensive care unit: a retrospective pre-post study.Critical care (London, England) · 2025
Article
Changes in Physical Function, Cognitive Function, Mental Health, and Sleep Quality After Cardiac Surgeries and Procedures.Nursing reports (Pavia, Italy) · 2025
Article
Comparative Study Between Medical/Surgical Intensive Care Units vs. Mixed Intensive Care Units in Key Performance Indicators.Cureus · 2024
Article

4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Jun FujinagaEmergency and Critical Care Center, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki City, Okayama, 710-8602, Japan. junf15june84@gmail.com.ORCID http://orcid.org/0000-0001-6222-7292

Takanao OtakeEmergency and Critical Care Center, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki City, Okayama, 710-8602, Japan.

Takehide UmedaEmergency and Critical Care Center, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki City, Okayama, 710-8602, Japan.

Toshio FukuokaEmergency and Critical Care Center, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki City, Okayama, 710-8602, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrevious studies have explored the association between the number of cases and patient outcomes for critical illnesses such as sepsis and trauma, as well as various surgeries, with the expectation that a higher number of cases would have a more favorable effect on patient outcomes. The aim of this study was to elucidate the association among intensive care unit (ICU) case volume, specialization, and patient outcomes in critically ill emergency patients and to determine how ICU case volumes and specializations impact the outcomes of these patients in Japanese ICUs.

methodsUtilizing data from the Japanese Intensive Care PAtient Database (JIPAD) from April 2015 to March 2021, this retrospective cohort study was conducted in 80 ICUs across Japan and included 72,214 emergency patients aged ≥ 16 years. The primary outcome measure was in-hospital mortality, and the secondary outcomes encompassed ICU mortality, 28-day mortality, ventilator-free days, and the lengths of ICU and hospital stays. Bayesian hierarchical generalized linear mixed models were used to adjust for patient- and ICU-level variables.

resultsThis study revealed a significant association between a higher ICU case volume and decreased in-hospital mortality. In particular, ICUs with a higher percentage (> 75%) of emergency patients showed more pronounced effects, with the odds ratios for in-hospital mortality in the higher case volume quartiles (Q2, Q3, and Q4) being 0.92 (95% credible interval [CI]: 0.88-0.96), 0.70 (95% CI: 0.67-0.73), and 0.78 (95% CI: 0.73-0.83), respectively, compared with the lowest quartile (Q1). Similar trends were observed for various secondary outcomes.

conclusionsHigher ICU case volumes were significantly associated with lower in-hospital mortality rates in Japanese ICUs predominantly treating critically ill emergency patients. These findings emphasize the importance of ICU specialization and highlight the potential benefits of centralized care for critically ill emergency patients. These findings are potential insights for improving health care policy in Japan and may be valuable in emergency care settings in other countries with similar healthcare systems, after careful consideration of contextual differences.

Indexed as

Case volumeCritically ill patientEmergency careIn-hospital mortalityNationwide cohort study

Identifiers

PMID38760868

DOI10.1186/s40560-024-00733-3

PMCPMC11100151

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LicenceCC BY

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.