BACKGROUND: Sepsis is a challenging condition increasingly managed in medical wards, however literature and clinical evidence in this hospital setting are lacking. METHODS: Using the computational i2b2 framework, we retrospectively analyzed data from patients admitted to internal medicine units of four hospitals in Lombardy (Italy) between January 2012 and December 2023, with a discharge diagnosis of sepsis, septic shock, or septicemia. RESULTS: A total of 4,375 patients were recruited. Median length of stay (LOS) was 14 days, and mean ward-to-intensive care unit (ICU) transfer and in-hospital mortality rates were 11 and 26%, respectively
significant differences were observed over the years, with LOS peaks preceding mortality peaks by 1 year. Blood culture-negative sepses showed shorter stays and higher mortality (acute kidney injury and fast deterioration) compared to culture-positive ones
polymicrobial sepses showed higher ICU transfer rates (acute respiratory distress)
while multidrug-resistant (MDR CONCLUSION: This work provides novel insights into sepsis management in internal medicine units, highlighting the need for validated biomarkers and implemented therapies in this scenario.