Length of stay and hospitalisation rates in Indonesian patients with paediatric hepatitis A: 2015-2021

Objective: To describe the trend in hepatitis-A virus (HAV)-related hospitalisations in children and analyse the association of demographic, clinical and laboratory manifestations with length of stay (LOS) of HAV infection.
Method: A retrospective study was conducted in Siloam Hospitals Indonesia. Inclusion criteria were hospitalised paediatric hepatitis A patients aged 3-17 years from 2015-2021. Another viral hepatitis was excluded. Total 58 samples were divided into non-prolonged group (LOS<5 days) and prolonged group (LOS≥5 days). Demographic data, clinical manifestations and laboratory parameters were collected and analysed using SPSS. Correlations with p <0.05 were considered significant.
Results: Hospitalisation rate pattern showed two peaks in 2016 and in 2019. The monocyte-to-leucocyte ratio (MLR), blood urea nitrogen (BUN), and creatinine were significantly associated with LOS in bivariate analysis. Medians of MLR and BUN were higher in the prolonged group (0.23; 17) than in the non-prolonged group (0.19; 15.98). Median of creatinine was lower in the prolonged group (0.55) than in the non-prolonged group (0.74). Multivariate analysis found that dark urine was less likely to have a prolonged LOS (OR: 0.23; 95% CI 0.06-0.91, p = 0.04).
Conclusions: Dark urine was a protective factor for prolonged LOS. Independently, higher BUN and higher MLR were risk factors for prolonged LOS.