Epidemiology and outcomes of septic shock in Japan: a nationwide retrospective cohort study from a medical claims database by the Japan Sepsis Alliance (JaSA) study group
Authors' conclusion
Despite improvements in survival and LOS over the past decade, septic shock remains a highly lethal and resource-intensive condition in Japan, with in-hospital mortality rates exceeding 30%. Mortality was particularly high among older patients, with rates consistently exceeding 40% among those aged ≥ 85 years.
Study context
- Population
- Adult inpatients (aged ≥ 18 years) with sepsis, Japanese Diagnosis Procedure Combination (DPC) nationwide medical claims database, 2010 to 2020patients with sepsis
- Participants
- 4,426,342 inpatients
- Exposure
- Septic shock vs non-shock sepsis
- Shockn = 649,082
- Outcome
- In-hospital mortality rate
Methodological detailsnationwide, medical claims database
- Nationwide
- Medical claims database
Main finding
As reported in the abstract
In-hospital mortality
P < 0.001
- In-hospital mortality decreased 2010 to 2020: shock group
- 46.7 to 33.2%
- In-hospital mortality decreased 2010 to 2020: non-shock group
- 26.0 to 18.0%
Observational data: associations, not effects.
Secondary outcomes
Hospital LOS
ICU admission
- Hospital length of stay (LOS) — Mean LOS decreased 2010 to 2020: shock group
- 61.0 to 53.6 days
- Hospital LOS — Mean LOS decreased 2010 to 2020: non-shock group
- 45.7 to 34.4 days
Intensive care unit (ICU) admission
- Mortality higher in non-ICU septic shock patients throughout most of the study period; difference diminished in 2019
Deaths per 1,000 inpatients, 2010 to 2020
- Shock group (slight decrease)
- 2.8 to 2.4
- Non-shock group (increase)
- 7.0 to 8.2
Proportion of patients with septic shock, 2010 to 2020
- Increased
- 0.64 to 0.83%
Mortality by age and sex (subgroup)
- Persistently high mortality among older patients (≥ 85 years) and males across the study period
Original publication
Epidemiology and outcomes of septic shock in Japan: a nationwide retrospective cohort study from a medical claims database by the Japan Sepsis Alliance (JaSA) study group. Crit Care. Published 16 July 2025. doi:10.
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