Sepsis Recognition and Management Gaps in Hospitals: A Post Hoc Analysis of a Subset of Data from the European Sepsis Care Survey

INTRODUCTION: Sepsis is a life-threatening condition and its management should be a hospital priority. The European Sepsis Care Survey (ESCS) investigated the implementation of guideline recommendations and the availability of infrastructure for sepsis care across Europe. Our objective was to provide a country‑level baseline assessment of sepsis care in hospitals and to identify deficiencies in sepsis recognition and management. METHODS: Data from 55 hospitals located in Poland were analyzed regarding sepsis definitions, screening, management, infrastructure, and quality improvement programs (QIPs) in emergency departments (EDs), wards, and intensive care units (ICUs). RESULTS: Sepsis-3 criteria were applied in 44% of hospitals. Sepsis screening and standardized management were used in 27% and 38.2% of EDs, 21% and 30.8% of wards, and 62% and 86.7% of ICUs, respectively. QIPs were present in 37% of hospitals, yet regular sepsis training across departments was reported by only 6.6%. In hospitals with QIPs, key indicators of sepsis care were monitored more frequently, including sepsis cases (76.5% versus 41.4%), mortality (70.6% versus 20.7%), time-to-antibiotics (29.4% versus 0%), bundle compliance (35.3% versus 0%), and also antibiotic stewardship (100% versus 58.6%) (all p < 0.05). Computed tomography (CT) or magnetic resonance imaging (MRI) was available 24 h a day in 94.2% of hospitals. Surgical source control was available 24 h a day in 92.7% of hospitals. Source control by interventional radiology was available in 34.5% of hospitals. Point-of-care lactate testing was available in 80% of emergency departments. Hospital guidelines for antimicrobial therapy in patients with sepsis were present in 65.5% of hospitals. CONCLUSIONS: Our study provides a country‑level baseline assessment of sepsis care in hospitals. Overall, adherence to established guidelines for sepsis recognition and management remains low and demands urgent improvement. Hospitals that implemented quality improvement programs demonstrated significantly higher compliance with these guidelines. Strengthening institutional support, establishing structured sepsis programs, and adopting systematic quality improvement approaches are essential to advancing sepsis care. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT05059808.