ICU-specific RAMRs for patients admitted with severe sepsis. Values denote the risk-adjusted mortality rate (RAMR) with 95% confidence interval for each of the 28 Dutch intensive care units (ICUs) participating in the study. The RAMR was calculated as follows: based on the case-mix correction model (which included the variables age, sex, SAPS II score, and number of dysfunctioning organ systems), the standardized mortality ratio (SMR) was calculated for each ICU by dividing the observed number of deaths by the number of deaths as expected by the model. The RAMR was subsequently calculated by multiplying the SMR with the overall mean mortality rate in the population of patients admitted with severe sepsis. Values are based on all patients admitted with severe sepsis between 1 January 2003 and 30 June 2005.