RESULTS: Over 4 years 1,303,640 patients were admitted with sepsis. Fifteen percent of the patients died, 30% discharged to home, 34% transferred to long term facility and 4% were transferred to another acute care facility. In-hospital mortality decreased from 16.5% to 13.8% (P<0.001). Length of stay decreased from 6.7 to 5.9 days (P<0.001). These reduction in mortality and LOS were seen despite an increase in the number of comorbidities and chronic conditions during the study period (P<0.001). Furthermore, there were no significant changes in total charges (P=0.47). Multivariate analysis revealed, compared to the patients who were discharged routinely, the strongest predictors of in-hospital mortality were respiratory (OR: 6.02[95% CI, 5.87-6.18]), cardiovascular (OR: 3.25[95% CI, 3.17-3.33]) and hepatic (OR: 2.79[95% CI, 2.69-2.91]) failure as well as neurologic events (OR: 2.77[95% CI, 2.68-2.86]). The predictors of transfer to another acute short term care were rural location (OR: 4.50[95% CI, 4.02-5.03]) and small size of the hospital (OR: 2.96 [95% CI, 2.69-3.26]). The predictors of transfer to long term care were receiving major procedure in the operating room (OR: 2.14[95% CI, 2.09-2.19]), suffering a neurologic event (OR: 1.97[95% CI, 1.93-2.02]) and the diagnosis of respiratory failure (OR: 2.68 [95% CI, 2.61-2.76]). Compared to routine discharge, weight loss was an independent predictor of transfer to long term care, acute short term care, and in-hospital mortality.