ICU sedation, delirium & recovery
Impact of the Standardized Intensive Care Unit Admission Ratio on Outcomes in Rapid Response System Activations: A Retrospective Multicenter Study in Japan
Authors' conclusion
Higher SIAR values were significantly associated with a lower incidence of CPC of 3 or higher or death within 30 days.
Study context
- Population
- Patients with rapid response system (RRS) activation, Japanese in-hospital emergency registry, 2018–2022, 35 institutions
- Participants
- 8,794 patients · 35 institutions
- Exposure
- Standardized intensive care unit (ICU) admission ratio (standardized ICU admission ratio (SIAR); actual/predicted ICU admissions) per institution, as a continuous exposure
- Outcome
- Death within 30 days (during hospitalization, max 30 days after RRS activation)
- Follow-up
- 30 days
Methodological detailsregistry-based, generalized estimating equation logistic regression with hospital-level clustering
- Registry-based
- Generalized estimating equation logistic regression with hospital-level clustering
Main finding
As reported in the abstract
Death within 30 days
Odds ratio (95% CI)P value
SIAR (per 0.1-unit increase)multivariable analysis
0.98(0.97–0.99)
P = 0.104Per 0.1-unit increase, as printed
- SIAR · univariable analysis; nonsignificant
- β −0.05 (95% CI −0.12 to 0.01); P = 0.108
Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Composite of CPC ≥3 or death within 30 daysSIAR (per 0.1-unit increase) · multivariable analysis | 0.94 (0.92–0.96) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
| Outcome | β (95% CI) | P value |
|---|---|---|
| Composite of CPC ≥3 or death within 30 daysSIAR · univariable analysis | −0.15 (−0.27 to −0.03) | P = 0.015 |
Institutional ICU admission rate and SIAR (descriptive)
- Median ICU admission rate (IQR 0.21 to 0.47)
- 0.33
- Median SIAR (IQR 0.75 to 1.17)
- 0.98
Original publication
Impact of the Standardized Intensive Care Unit Admission Ratio on Outcomes in Rapid Response System Activations: A Retrospective Multicenter Study in Japan. Anesthesiology. Published 30 July 2025. doi:10.
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