Fluid balance status not linked to readmission chances for patients with sepsis:JAMA
Results from a large observational study of non-critically ill patients hospitalized with sepsis has highlighted no association between positive fluid balance at the time of discharge and readmission. However, these findings may have been limited by variable recording and documentation of fluid intake and output, the study team suggested. The findings have been put forth in JAMA Network Open.
Although early fluid administration has been shown to lower sepsis mortality, positive fluid balance has been associated with adverse outcomes. Little is known about associations in non–intensive care unit settings, with growing concern about readmission from excess fluid accumulation in patients with sepsis.
With this knowledge,a team of researchers from the Department of Hospital Medicine, Santa Rosa, California aimed to evaluate whether positive fluid balance among non–critically ill patients with sepsis was associated with increased readmission risk, including readmission for heart failure.
This multicenter retrospective cohort study was conducted between January 1, 2012, and December 31, 2017, among 57 032 non–critically ill adults hospitalized for sepsis at 21 hospitals across Northern California. Kaiser Permanente Northern California is an integrated health care system with a community-based population of more than 4.4 million members. Statistical analysis was performed from January 1 to December 31, 2019. Intake and output net fluid balance were (I/O) measured daily and cumulatively at discharge (positive vs negative). The primary outcome was 30-day readmission. The secondary outcomes were readmission stratified by category and mortality after living discharge.
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