Association Between In-Hospital Mortality and ICU Patient Volume at the Facility-Level Stratified by Severity
Authors' conclusion
Increased volumes of patients with severe illnesses were associated with decreased in-hospital mortality rates; this inverse volume-outcome relationship became more pronounced as the severity threshold increased.
Study context
- Population
- Adults admitted to the ICU in 430 Japanese hospitals (Diagnosis Procedure Combination inpatient database), October 1, 2020–March 31, 2023
- Participants
- 568,340 adults · 430 hospitals
- Exposure
- Facility-level annual ICU patient volume above Sequential Organ Failure Assessment (SOFA) score thresholds
- Outcome
- In-hospital mortality
Methodological detailsnationwide database, multilevel mixed-effects logistic regression
- Nationwide database
- Multilevel mixed-effects logistic regression
Main finding
As reported in the abstract
In-hospital mortality by facility-level ICU volume
Estimate (95% CI)P value
Total ICU volume (per 10-patient increase)
aOR 0.999(0.999–1.000)
P = 0.147Volume of ICU patients above SOFA score threshold of 5decreased in-hospital mortality
OR 0.997(0.995–0.998)
P < 0.001Per 10-patient increase, as printed
Observational data: associations, not effects.
Original publication
Association Between In-Hospital Mortality and ICU Patient Volume at the Facility-Level Stratified by Severity. Crit Care Med. Published 5 August 2026. doi:10.
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