Fluid balance status not linked to readmission chances for p
This large observational study of non–critically ill patients with sepsis presents no association between positive fluid balance and readmission.

Although early fluid administration has been shown to lower sepsis mortality, a positive fluid balance has been associated with adverse outcomes. This study evaluates 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 among 57?032 non–critically ill adults hospitalized for sepsis. Statistical analysis was performed. The primary outcome was 30-day readmission. The secondary outcomes were readmission stratified by category and mortality after living discharge.

- Compared with patients with positive I/O, those with negative I/O were older, with increased comorbidity, acute illness severity, preexisting heart failure or chronic kidney disease, diuretic use, and decreased fluid administration volume.

- During 30-day follow-up, 8719 patients were readmitted and 3639 patients died. There was no difference in readmission between patients with positive vs negative I/O.

- No association was detected between readmission and I/O using continuous, splined, and quadratic function transformations.

- Positive I/O was associated with decreased heart failure-related readmission and increased 30-day mortality.

In particular, there was 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.

Source: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2780601