Timely Antibiotics and Fluid Resuscitation Increase Discharge Home After Sepsis

Document Type

Conference Proceeding

Publication Date

3-2026

Publication Title

Critical Care Medicine

Abstract

INTRODUCTION: Sepsis is a devastating condition with high mortality and high rates of discharge to post-acute care facilities. We sought to examine the impact of timely antibiotic delivery and fluid resuscitation on discharge home after sepsis. METHODS: Observation cohort study of adults hospitalized with community-onset sepsis at 67 hospitals participating in the Michigan Hospital Medicine Safety Consortium sepsis initiative (HMS-Sepsis) during 2022-2024. HMS is a collaborative quality initiative sponsored by Blue Cross Blue Shield of Michigan. Professional abstractors at each hospital enter data on a random sample of eligible hospitalizations into the HMS-Sepsis registry, which is used for statewide performance benchmarking. We used multivariable regression to examine the association between early sepsis treatments and outcome—both overall and among the subset of patients discharged alive. We adjusted for predicted probability of discharge home using a high-performing risk-prediction model based on admission physiology and chronic health conditions (c-statistic ≥0.84). RESULTS: Among 38,568 patients with community-onset sepsis (18,941 male [49.1%]; median [IQR] age, 71 [61-80] years), 7,942 (20.6%) died in-hospital or were discharged to hospice, 9,941 (25.8%) were discharged to post-acute care, and 20,685 (53.6%) were discharged home. Among 35,025 and 27,393 eligible patients, timely antibiotic delivery and fluid resuscitation occurred in 26,357 (75.3%) and 13,561 (49.5%), respectively. In multivariable models adjusted for patient characteristics, timely antibiotics and fluid resuscitation were associated with 3.1(95% CI: 2.8- 3.5) and 1.3 (95% CI 1.3-1.4) percentage point increases in discharge to home, respectively. In analyses limited to hospital survivors, timely antibiotic delivery was associated with increased discharge home, while fluid resuscitation was not associated with discharge home. CONCLUSIONS: In this multihospital cohort, timely antibiotic delivery was associated with increased discharge home after sepsis. Conditional on survival, timely antibiotic delivery remained associated with increased discharge home, suggesting that timely antibiotic delivery not only improves survival but also reduces downstream morbidity from sepsis.

Volume

54

Issue

3S

Comments

Society for Critical Care Medicine 55th Critical Care Congress, March 27-24, 2026, Chicago, IL

DOI

10.1097/01.ccm.0001184992.86703.e6

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