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RESULTS Among 1,058,510 ICU admissions, adherence to VTE and stress ulcer prophylaxis was high across acuity levels. In adjusted analyses, those admitted to low-acuity ICUs compared to the highest-acuity ICUs were more likely to experience hypoglycemic events (adjusted odds ratio [aOR] 1.12, 95% confidence interval [CI] 1.04-1.2, sustained hyperglycemia (aOR 1.07, 95% CI 1.04-1.1, and liberal transfusion practices (aOR 1.55, 95% CI 1.33-1.82). INTERPRETATION High ICU acuity is associated with better adherence to several evidence-bas