A multihospital cohort study found that early sepsis care measures, including timely antibiotic administration and indicated fluid resuscitation, were associated with a greater likelihood of discharge to home among adults hospitalized with community-onset sepsis.
The analysis included more than 38,000 patients treated at 67 hospitals participating in the Michigan Hospital Medicine Safety Consortium’s sepsis initiative between 2022 and 2025. Overall, about 54% of patients were discharged to home, 26% were discharged to a post-acute care facility, and 21% died in the hospital or were discharged to hospice.
Researchers evaluated two early sepsis management practices used for statewide benchmarking: timely antibiotic administration and fluid resuscitation of at least 30 mL/kg when indicated. Among eligible patients, about 75% received antibiotics within the target time frame and about 50% received the fluid measure.
After adjustment for patient characteristics, timely antibiotic administration was associated with a 3 percentage point higher likelihood of discharge to home, while fluid resuscitation was associated with a 1 percentage point increase. Similar findings were observed across multiple sensitivity analyses and in subgroup analyses excluding patients admitted from skilled nursing or rehabilitation facilities.
Among hospital survivors, timely antibiotic delivery remained associated with increased discharge to home, while fluid resuscitation did not. The researchers noted this pattern suggests prompt antibiotic treatment may influence not only short-term survival but also downstream recovery after sepsis, although causality cannot be established.
The researchers noted that sepsis quality efforts often focus on mortality and readmission, but discharge location may better capture functional recovery and downstream health care use. They suggested that improving early sepsis management could affect not only survival, but also the likelihood of returning home rather than requiring institutional post-acute care.
The study was observational, and residual confounding could not be excluded. The researchers also cautioned that discharge to home, although generally favorable and less costly, may not always reflect the most appropriate disposition for every patient.
Source: Chest(journal pre-proof)
Disclosures: This study appears as a journal pre-proof and has not yet undergone final copyediting and production. The work was supported by Blue Cross Blue Shield of Michigan and the National Heart, Lung, and Blood Institute. Several researchers receive salary support from Blue Cross Blue Shield of Michigan for work on the Michigan Hospital Medicine Safety Consortium. One researcher serves on the Surviving Sepsis Campaign guidelines and is a paid scientific consultant to Aurobac Therapeutics.
