Table 3.
Subgroup analysis of mortality and cost-effectiveness by information on age, admission, surgery, and SOFA scores
| ICU mortality | p value | In-hospital mortality | p value | Difference in cost (JPY) | Difference in life expectancy (years) | Difference in LYG (years) | Difference in QALY (years) | ICER (JPY/QALY) | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Number of deaths/number of patients, % | Number of deaths/number of patients, % | ||||||||||||||
| ICU1/2 | % | ICU3/4 | % | ICU1/2 | % | ICU3/4 | % | ||||||||
| Overall | 1870/71,412 | 2.6 | 1983/46,330 | 4.3 | < 0.001 | 4361/71,412 | 6.1 | 4102/46,330 | 8.9 | < 0.001 | 566,724 | 1.93 | 1.25 | 0.79 | 718,659 |
| Age, years | |||||||||||||||
| Subgroup 1 (≦ 51) | 177/9862 | 1.8 | 144/5128 | 2.8 | < 0.001 | 387/9,862 | 3.9 | 248/5128 | 4.8 | < 0.001 | 566,300 | 1.60 | 1.06 | 0.67 | 850,693 |
| Subgroup 2 (52–63) | 218/11,321 | 1.9 | 204/6600 | 3.1 | < 0.001 | 537/11,321 | 4.7 | 375/6600 | 5.7 | < 0.001 | 488,301 | 0.27 | 0.18 | 0.11 | 4,344,097 |
| Subgroup 3 (64–74) | 494/23,067 | 2.1 | 480/14,425 | 3.3 | < 0.001 | 1203/23,067 | 5.2 | 945/14,425 | 6.6 | < 0.001 | 488,134 | 0.30 | 0.17 | 0.11 | 4,584,021 |
| Subgroup 4 (≧ 75) | 981/27,162 | 3.6 | 1155/20,177 | 5.7 | < 0.001 | 2234/27,162 | 8.2 | 2534/20,177 | 12.6 | < 0.001 | 669,908 | 0.71 | 0.50 | 0.31 | 2,145,136 |
| Admission type | |||||||||||||||
| Elective admission | 243/45,495 | 0.5 | 158/24,645 | 0.6 | 0.073 | 718/45,495 | 1.6 | 394/24,645 | 1.6 | 0.836 | 382,141 | 1.14 | 0.74 | 0.46 | 824,716 |
| Emergency admission | 1627/25,917 | 6.3 | 1825/21,685 | 8.4 | < 0.001 | 3643/25,917 | 14.1 | 3708/21,685 | 17.1 | < 0.001 | 713,846 | 2.23 | 1.45 | 0.91 | 782,439 |
| Emergency surgery | 486/15,840 | 3.1 | 420/10,743 | 3.9 | < 0.001 | 1525/15,840 | 9.6 | 1208/10,743 | 11.2 | < 0.001 | 605,377 | 1.71 | 1.11 | 0.78 | 776,991 |
| SOFA scores | |||||||||||||||
| Subgroup 1 (0–2) | 25/4385 | 0.6 | 27/4010 | 0.7 | 0.547 | 97/4385 | 2.2 | 136/4010 | 3.4 | < 0.001 | 365,369 | 2.04 | 1.32 | 0.93 | 394,081 |
| Subgroup 2 (3–5) | 48/4396 | 1.1 | 66/2946 | 2.2 | < 0.001 | 253/4396 | 5.8 | 264/2946 | 9.0 | < 0.001 | 478,963 | 2.60 | 1.69 | 1.18 | 404,594 |
| Subgroup 3 (6–8) | 74/3445 | 2.1 | 86/1866 | 4.6 | < 0.001 | 315/3445 | 9.1 | 272/1866 | 14.6 | < 0.001 | 502,951 | 2.27 | 1.48 | 1.03 | 486,621 |
| Subgroup 4 (9–11) | 137/2292 | 6.0 | 97/1198 | 8.1 | 0.017 | 411/2292 | 17.9 | 261/1198 | 21.8 | 0.006 | 507,200 | 2.02 | 1.31 | 0.92 | 552,667 |
| Subgroup 5 (12–14) | 130/1030 | 12.6 | 89/538 | 16.5 | 0.033 | 305/1030 | 29.6 | 180/538 | 33.5 | 0.118 | 566,486 | 1.46 | 0.95 | 0.67 | 850,518 |
| Subgroup 6 (15–24) | 72/292 | 24.7 | 55/185 | 29.7 | 0.222 | 144/292 | 49.3 | 95/185 | 51.4 | 0.665 | 786,602 | 2.58 | 1.67 | 1.17 | 671,005 |
| Elective surgery | 143/44,864 | 0.3 | 97/24,292 | 0.4 | 0.085 | 520/44,864 | 1.2 | 288/24,292 | 1.2 | 0.757 | 381,083 | 1.12 | 0.73 | 0.52 | 736,932 |
| SOFA scores | |||||||||||||||
| Subgroup 1 (0–2) | 4/20,949 | 0.0 | 4/14,257 | 0.0 | 0.584 | 40/20,949 | 0.2 | 39/14,257 | 0.3 | 0.108 | 174,093 | 1.57 | 1.02 | 0.72 | 240,206 |
| Subgroup 2 (3–5) | 12/12,702 | 0.1 | 9/5527 | 0.2 | 0.211 | 78/12,702 | 0.6 | 56/5527 | 1.0 | 0.004 | 303,501 | 1.27 | 0.83 | 0.59 | 516,341 |
| Subgroup 3 (6–8) | 28/6366 | 0.4 | 10/2323 | 0.4 | 0.953 | 97/6,366 | 1.5 | 47/2323 | 2.0 | 0.106 | 365,490 | 1.78 | 1.15 | 0.82 | 445,860 |
| Subgroup 4 (9–11) | 29/3409 | 0.9 | 25/1537 | 1.6 | 0.015 | 121/3,409 | 3.5 | 64/1537 | 4.2 | 0.292 | 309,338 | 1.53 | 1.00 | 0.71 | 437,516 |
| Subgroup 5 (12–14) | 35/1174 | 3.0 | 30/530 | 5.7 | 0.008 | 108/1,174 | 9.2 | 56/530 | 10.6 | 0.376 | 348,303 | 0.79 | 0.51 | 0.36 | 961,209 |
| Subgroup 6 (15–24) | 35/264 | 13.3 | 19/118 | 16.1 | 0.008 | 76/264 | 28.8 | 26/118 | 22.1 | 0.168 | 1,451,111 | 1.13 | 0.73 | 0.52 | 2,782,327 |
| Non-surgery | 1241/10,708 | 11.6 | 1466/11,295 | 13.0 | 0.002 | 2,316/10,708 | 21.6 | 2606/11,295 | 23.1 | 0.010 | 398,879 | 2.33 | 1.51 | 0.92 | 432,369 |
| SOFA scores | |||||||||||||||
| Subgroup 1 (0–2) | 43/2653 | 1.6 | 62/3781 | 1.6 | 0.953 | 111/2653 | 4.2 | 191/3781 | 5.1 | 0.001 | 242,197 | 3.56 | 2.31 | 1.41 | 171,521 |
| Subgroup 2 (3–5) | 116/3222 | 3.6 | 187/3391 | 5.5 | < 0.001 | 375/3222 | 11.6 | 489/3391 | 14.4 | < 0.001 | 443,260 | 3.18 | 2.07 | 1.26 | 351,592 |
| Subgroup 3 (6–8) | 251/2368 | 10.6 | 275/2051 | 13.4 | 0.004 | 562/2368 | 23.7 | 602/2051 | 29.4 | < 0.001 | 564,818 | 2.97 | 1.93 | 1.18 | 479,695 |
| Subgroup 4 (9–11) | 297/1392 | 21.3 | 363/1095 | 33.2 | < 0.001 | 548/1392 | 39.4 | 575/1095 | 52.5 | < 0.001 | 625,128 | 3.70 | 2.40 | 1.47 | 426,560 |
| Subgroup 5 (12–14) | 302/709 | 42.6 | 350/665 | 52.6 | < 0.001 | 428/709 | 60.4 | 482/665 | 72.5 | < 0.001 | 471,555 | 2.24 | 1.45 | 0.89 | 531,997 |
| Subgroup 6 (15–24) | 232/361 | 63.7 | 229/312 | 73.4 | 0.007 | 292/361 | 80.2 | 267/312 | 85.6 | 0.066 | 654,238 | 0.80 | 0.52 | 0.32 | 2,054,148 |
ICU intensive care unit, ICER incremental cost-effectiveness ratio, JPY Japanese Yen, LYG life year gained, QALY quality-adjusted life years, QOL quality of life, SOFA Sequential Organ Failure Assessment