Predictors of and hospital-level variation in intensive care unit readmissions in Japan: a nationwide inpatient database study
Authors' conclusion
In Japan, early ICU readmissions are less frequent than in most Western countries and often occur long after discharge. Discharge severity scores, rather than disease severity at admission, served as the key predictors of readmission.
Study context
- Population
- Adults discharged alive after their initial intensive care unit (ICU) stay with Sequential Organ Failure Assessment (SOFA) scores at ICU admission and discharge, Japan Diagnosis Procedure Combination database, 2018–2023
- Participants
- 552,545 adults · 401 hospitals
- Outcome
- Early ICU readmission (within ≤ 2 full calendar days after initial ICU discharge)
Methodological detailsnationwide, multilevel logistic regression
- Nationwide
- Multilevel logistic regression
Main finding
As reported in the abstract
Early ICU readmission
Early ICU readmission
4728 patients
0.9%
Observational data: associations, not effects.
Further findings
All ICU readmissions (early and late combined)
- ICU readmission
- 22,112 patients (4.0%)
- Readmissions occurring ≥ 14 days after initial ICU discharge
- 32.8%
- Readmissions occurring ≥ 30 days after initial ICU discharge
- 12.2%
- Intermediate care transfer not protective against overall readmission
- Temporal distribution lacked an early peak
Hospital-level variation
- Intraclass correlation coefficients (ICC)
- 14-15%
- Median odds ratios (MOR)
- ≈2.0
- Persisted after adjusting for patient- and hospital-level factors
Original publication
Predictors of and hospital-level variation in intensive care unit readmissions in Japan: a nationwide inpatient database study. J Intensive Care. Published 29 November 2025. doi:10.
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