Predictors of length of stay between the young and aged in hospitalized community-acquired pneumonia patients.
OBJECTIVE
To determine the factors that may prolong the length of stay (LOS) for older patients hospitalized for community-acquired pneumonia (CAP) and also to see if they are applicable to the younger patients.


METHODS
A retrospective case record review was conducted of all adult patients who were discharged from the general medical service or the geriatric medicine service of an acute care hospital over 6 months.


RESULTS
During the study period, 393 patients were discharged with the diagnosis of pneumonia. Based on the study criteria, 200 patients were included in the study. Of the elderly patients, 39% had severe pneumonia compared to 9.3% in the younger group (P < 0.001), resulting in a higher mortality rate. All patients with severe pneumonia had serum albumin levels of less than 3.7 g/dL. The median LOS was significantly shorter in the younger patients (4 days) compared to the elderly patients (9 days, P < 0.001). Severe pneumonia, dysphagia, chronic renal disease, hypoalbuminemia and older age group were found to be significantly associated with longer LOS.


CONCLUSIONS
Compared to younger patients, older subjects aged 65 years and above hospitalized with CAP were more likely to have severe pneumonia and longer LOS. Presence of severe pneumonia, dysphagia, chronic renal disease, hypoalbuminaemia and age of more than 65 years were significantly associated with longer LOS for all patients. However, in the younger group, only hypoalbuminaemia remained a significant factor. In the elderly patients, severe pneumonia, dysphagia and type of residence were important factors predicting longer LOS.
Kaysar
Mamun
M
Singapore General Hospital, Geriatric Medicine, Singapore. kaysar.mamun@sgh.com.sg
Augustine
Tee
T
Jim
Lim
L
Benjamin
Castasus
C
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000150:complications / Q000175:diagnosis; D005260:Female; D016330:Frail Elderly; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications* / Q000175:diagnosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult