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Patients discharged fromthe ED with fluid and electrolyte disorders (FED) andaltered mental status (AMS) were most likely to have downstream sepsis hospitalizations (OE ratios of 2.66 and2.82, respectively). Temporal analyses revealed that these symptoms were overrepresented and temporally clustered close to the hospitalization date. Approximately 2% of sepsis hospitalizations were associated with prior FED or AMS ED visits. Treat-and-release ED encounters for FED and AMS may represent harbingers for downstream sepsis hospitalizations. The SPADE approach ca