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Table 1. Descriptive Data of the Characteristics and Distribution of the Target Hospitals and ICUS.

From: Regional Differences and Mortality-associated Risk Factors among Older Patients with Septic Shock: Administrative Data Analysis with Multilevel Logistic Regression Modelling

Variable Number of ICUs (%)
Number of hospital beds ≥400 18 51.4
<400 17 48.6
Proportion of ICU beds to hospital beds <1.5% 12 34.3
1.5-3% 12 34.3
≥3% 11 31.4
ICU bed-to-board certified physician ratios ≤4 7 20
>4 9 25.7
No certified physician 19 54.3
Type of SICM fee Resource rich 6 17.1
Standard 29 82.9
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Table 2. Comparison of the Participants’ Characteristics and Treatments.

From: Regional Differences and Mortality-associated Risk Factors among Older Patients with Septic Shock: Administrative Data Analysis with Multilevel Logistic Regression Modelling

Variable Secondary Medical Area
1 2 3 4 5 6 7 8 9 p
N 295 29 41 70 186 20 157 372 68
Age, y (median, IQR) 83 (9) 84 (10) 84 (6) 83.5 (8) 83 (8) 86 (7) 84 (8) 83 (8) 83 (7) 0.20
Sex, male (%) 57.3 65.5 53.7 48.6 60.8 50 53.5 55.1 48.5 0.55
CCI, median (IQR) 2 (2) 2 (3) 1 (2) 2 (2) 2 (2) 0 (2.5) 2 (2) 2 (2) 2 (2) 0.88
Postoperative (%) 30.5 44.8 31.7 45.7 41.4 35 34.4 42.2 25 0.01
Vasopressor use (%)
　Noradrenaline 84.4 82.8 70.7 82.9 82.8 65 91.7 86.8 83.9 0.02
　Vasopressin 5.4 3.5 2.4 1.4 22 0 49.7 8.1 17.7 <0.01
　Dopamine 54.6 55.2 63.4 31.4 31.2 55 21.7 38.2 36.8 <0.01
　Adrenaline 6.8 6.9 4.9 7.1 9.1 5 15.9 11.6 8.8 0.09
Antibiotic use (%)
　Carbapenems 64.4 65.5 58.5 58.6 54.3 25 75.2 53.2 48.5 <0.01
　Anti-MRSA agents* 9.2 10.3 2.4 4.3 18.8 5 32.5 12.6 8.8 <0.01
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Table 3. Mortality Rates in the Secondary Medical Areas.

From: Regional Differences and Mortality-associated Risk Factors among Older Patients with Septic Shock: Administrative Data Analysis with Multilevel Logistic Regression Modelling

Secondary medical area n 28-Day mortality (%) OR (95% CI) SE p
1 295 32.2 2.12 (1.36-3.31) 0.482 <0.01
2 29 41.4 3.16 (1.38-7.22) 1.332 <0.01
3 41 31.7 2.08 (0.98-4.42) 0.800 0.06
4 70 25.7 1.55 (0.81-2.97) 0.515 0.19
5 186 18.3 Reference
6 20 40.0 2.98 (1.13-7.85) 1.473 0.03
7 157 22.9 1.33 (0.79-2.25) 0.357 0.29
8 372 33.6 2.26 (1.47-3.48) 0.496 <0.01
9 68 38.2 2.77 (1.50-5.12) 0.868 <0.01
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Table 4. The Variance Inflation Factor (VIF) for Each Variable.

From: Regional Differences and Mortality-associated Risk Factors among Older Patients with Septic Shock: Administrative Data Analysis with Multilevel Logistic Regression Modelling

Variable VIF 1/VIF
Age group
80-84 1.53 0.65
85-89 1.51 0.66
≥90 1.40 0.71
≥3% 11 31.4
Sex 1.06 0.94
CCI Moderate 1.04 0.97
No certified physician 19 54.3
Severe 1.03 0.97
Fiscal year 2016 1.64 0.61
2017 1.62 0.62
2018 1.68 0.60
2019 1.63 0.61
Number of hospital beds 1.80 0.56
ICU bed-to-board certified physician ratios > 4 3.80 0.26
No certified physician 3.75 0.27
Proportion of ICU beds to hospital beds 1.5-3% 1.85 0.54
Number of hospital beds ≥3% 1.79 0.56
Type of SICM fee 1.75 0.57
Procedure 1.04 0.96
Mean VIF 1.76
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Table 5. Results of the Multilevel Logistic Regression Analyses.

From: Regional Differences and Mortality-associated Risk Factors among Older Patients with Septic Shock: Administrative Data Analysis with Multilevel Logistic Regression Modelling

Variable Null Model Model 1 Model 2
OR (95% CI) p AOR (95% CI) p AOR (95% CI) p
Age group, y 75-79 Reference Reference
80-84 1.29 (0.92-1.81) 0.14 1.28 (0.91-1.80) 0.15
85-89 1.47 (1.04-2.08) 0.03* 1.49 (1.05-2.11) 0.03
≥90 1.82 (1.19-2.76) 0.01* 1.86 (1.22-2.83) <0.01
Sex Male Reference Reference
Female 0.74 (0.57-0.96) 0.03* 0.73 (0.56-0.94) 0.02
Fiscal year 2015 Reference Reference
2016 1.14 (0.76-1.70) 0.52 1.12 (0.75-1.67) 0.58
2017 1.17 (0.79-1.75) 0.44 1.16 (0.78-1.74) 0.46
2018 0.89 (0.60-1.32) 0.57 0.87 (0.59-1.30) 0.51
2019 1.09 (0.73-1.63) 0.69 1.10 (0.73-1.64) 0.66
CCI Mild Reference Reference
Moderate 1.07 (0.83-1.38) 0.60 1.10 (0.85-1.41) 0.48
Severe 1.21 (0.35-4.17) 0.76 1.28 (0.37-4.38) 0.70
Procedure Postoperative 0.62 (0.47-0.81) <0.01* 0.62 (0.47-0.81) <0.01
Number of hospital beds ≥400 Reference
<400 0.87 (0.61-1.25) 0.46
Proportion of ICU beds to hospital beds <1.5% Reference
1.5-3% 1.14 (0.77-1.70) 0.51
≥3% 0.88 (0.60-1.30) 0.52
ICU bed-to-board certified physician ratios ≤4 Reference
>4 1.33 (0.77-2.31) 0.30
No certified physician 1.99 (1.15-3.44) 0.01
Type of SICM fee Resource rich Reference
Standard 0.85 (0.57-1.28) 0.44
Log likelihood −747.96 −734.35 −729.94
Variance SMA 0.06 (0.01-0.44) 0.05 (0.01-0.51) 0.03 (0.00-0.50)
Hospital 0.03 (0.00-0.43) 0.04 (0.00-0.42) 0.01 (0.00-17.07)
ICC SMA 0.02 (0.00-0.12) 0.02 (0.00-0.13) 0.01 (0.00-0.13)
Hospital 0.03 (0.01-0.09) 0.03 (0.01-0.09) 0.01 (0.00-0.07)
MOR SMA 1.26 (1.09-1.88) 1.24 (1.07-1.97) 1.16 (1.04-1.97)
Hospital 1.19 (1.05-1.87) 1.22 (1.07-1.86) 1.10 (1.00-51.44)
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