2022 Volume 29 Issue 2 Pages 107-116
Objective: The state of prolonged ICU stays (ICU-LOS) in Japanese intensive care units is unknown. Using the Japanese Intensive Care Patient Database (JIPAD), we investigated ICU-LOS in Japan. Method: Data on adult patients (≧ 16 years old) other than burn patients and patients admitted for minor treatments who were admitted to an ICU between April 1, 2015, and March 31, 2019, were retrieved from JIPAD. The patients were divided into short-term (≦14 days) and long-term (≧15 days) groups based on their ICU-LOS. The APACHEⅡandⅢ scores, ICU-LOS, hospital-LOS, and total number of ICU-bed days were then compared between the two groups. ICU-LOS was categorized into 0, 1, 2-7, 8-14, 15-21 and ≧22 days, and hospital mortality after ICU discharge was compared according to the ICU-LOS categories after adjustments for other factors, such as the APACHEⅢ scores. Results: Among 79,620 patients admitted to ICU during the study period, 2,364 patients (3.0%) remained in ICU for more than 14 days. Long-term patients had severer illnesses and required more intensive treatments such as a mechanical ventilator or hemodialysis. The long-term group occupied 25.0% of all ICU bed days, and Japanese medical insurance claims for ICU bed fees were not made for 47.6% of the occupied beds. The ICU- and hospital- mortality rates were higher in the long-term group. Hospital mortality after ICU discharge was significantly higher for the long-term ICU-LOS group. Conclusion: According to JIPAD data, 3.0% of severely ill adult patients admitted to Japanese ICUs remained in the ICU for more than two weeks, and a longer ICU-LOS was associated with a higher mortality rate.
