Clinical Predictors of Prolonged Hospitalization in Children with Community-Acquired Pneumonia

TL;DR

The study identifies factors like severe pneumonia, complications, and chronic conditions that predict longer hospital stays in children with pneumonia, helping doctors provide better care.

Contribution

The study identifies independent clinical predictors of prolonged hospitalization in pediatric community-acquired pneumonia patients.

Findings

Moderate-to-severe pneumonia, complications, and chronic conditions independently predict prolonged hospitalization in 27.5% of children.

Early identification of these predictors allows for targeted interventions to reduce hospital length of stay.

Abstract

What are the main findings?
•Disease severity, pneumonia complications, and chronic medical conditions independently predict prolonged hospitalization (≥10 days) in 27.5% of children with community-acquired pneumonia.•Early identification of these predictors enables risk stratification at admission and the implementation of targeted interventions to reduce length of stay.

Disease severity, pneumonia complications, and chronic medical conditions independently predict prolonged hospitalization (≥10 days) in 27.5% of children with community-acquired pneumonia.

Early identification of these predictors enables risk stratification at admission and the implementation of targeted interventions to reduce length of stay.

What are the implications of the main findings?
•Recognizing these predictors at admission allows for early risk stratification and more accurate caregiver counseling.•Quality-improvement projects should focus on streamlining care and implementing tailored pathways to reduce unnecessary hospital delays.

Recognizing these predictors at admission allows for early risk stratification and more accurate caregiver counseling.

Quality-improvement projects should focus on streamlining care and implementing tailored pathways to reduce unnecessary hospital delays.

Objectives: This study aimed to identify key predictors of prolonged hospitalization in children with community-acquired pneumonia by comparing demographic and clinical characteristics between patients with expected and extended hospital stays. Methods: A retrospective cohort study was conducted for children younger than 15 years hospitalized with pneumonia between May 2015 and March 2020. Patients with hospital-acquired pneumonia or additional diagnoses were excluded. Demographic and clinical variables were collected. Statistical analysis, including logistic regression, was performed using SPSS v28 to identify independent predictors of prolonged hospitalization. Results: A total of 455 pediatric patients were included, with a median age of 2 years and a median length of stay of 6 days. Prolonged hospitalization occurred in 27.5% (n = 125) of cases. Gender distribution did not differ significantly between groups (p = 0.727). Significant predictors of prolonged hospitalization included moderate-to-severe pneumonia (p < 0.001, OR = 9.7, 95% CI = 3.1–30.9), pneumonia complications (p = 0.019, OR = 15.16, 95% CI = 1.57–146.3), and underlying chronic conditions (p = 0.009, OR = 2.88, 95% CI = 1.3–6.4). While hypoxia, ventilatory support, and bacteremia were associated with prolonged stay, they did not emerge as independent predictors in the final multivariable model. Conclusion: Prolonged hospitalization in pediatric pneumonia is strongly associated with increased disease severity, complications, and chronic comorbidities. Early identification of high-risk patients may facilitate targeted management strategies, improve outcomes, and reduce healthcare burden.

Figures