Factors correlate with prolonged hospitalization in pediatric pneumonia: A retrospective analysis

Background: Community Acquired Pneumonia (CAP) is a common cause of pediatric hospitalization and remains a significant contributor to morbidity and healthcare burden globally. Prolonged hospital stays can complicate outcomes and strain healthcare systems. Identifying predictors of hospital stay duration may inform clinical decision-making and optimize care. This study aims to investigate clinical and biochemical factors correlate with the duration of hospitalization among pediatric patients with pneumonia.

Methods: A retrospective study conducted at a tertiary pediatric hospital Baghdad Iraq, over 6-months period on pediatric patients aged 2 months to <15 years diagnosed with CAP. Data collected included demographics, Clinical signs including vital signs at admission, and peripheral oxygen saturation (Spo2), duration of dyspnea, and time to defervescence. Laboratory parameters: white blood cell (WBC) count, absolute lymphocyte count, absolute neutrophil count, C-reactive protein (CRP) level, serum potassium, and serum sodium concentrations.

Results: A total of 240 child diagnosed with pneumonia were included. The average hospital stay were 7 ± 4.99 days with 142 (59.2%) had more than 7 days of hospitalization. Those had significantly higher mean respiratory rates, heart rate and body temperature and lower oxygen saturation levels. In addition, laboratory tests in children with prolonged hospitalization showed significantly higher WBC counts, neutrophil counts, and CRP levels with P-value (<0.001, 0.005, and <0.001 respectively). On logistic regression, three independent predictors were significantly associated with increased odds for prolonged hospital stay including elevated body temperature (OR= 6.194, 95% CI: 2.108-18.199; P= 0.001), and lower oxygen saturation at time of admission (OR=0.783, 95% CI: 0.616-0.994; P=0.045) and heart rate (OR=0.947,95% CI: 0.906-0.990; P= 0.017).

Conclusion: clinical signs at time of admission indicative of severe pneumonia -namely tachycardia, elevated body temperature, and hypoxia can be used to predict prolonged hospitalization in pediatric patients diagnosed with pneumonia.