[Factors associated with prolonged hospital stay in community-acquired pneumonia].
BACKGROUND
The length of hospital stay in patients with community-acquired pneumonia (CAP) varies considerably, even though this factor has a great impact on the cost of care for this condition. The objective of this study was to identify factors associated with prolonged hospitalization in these patients (>8 days).


METHODS
Observational analysis of a prospective cohort of nonimmunosuppressed adults with CAP requiring hospitalization from 1995 through 2006.


RESULTS
We documented a total of 2688 consecutive episodes of CAP. Patients who required intensive care unit admission from the emergency room (n=107), those who died during hospitalization (n=200), and patients hospitalized for more than 30 days (n=60) were excluded from the analysis. The median duration of hospital stay was 8 days (IQR, 6-11). Factors independently associated with prolonged hospital stay by stepwise multiple logistic regression analysis were advanced age (OR=1.58; 95% CI, 1.002-2.503), alcohol abuse (OR=2.07; 95% CI, 1.341-3.199), high-risk Pneumonia Severity Index class (OR=1.72; 95% CI, 1.094-2.703), aspiration pneumonia (OR=4.57; 95% CI, 1.085-19.285), pleural empyema (OR=3.73; 95% CI, 1.978-7.04), and time to clinical stability (OR=1.13; 95% CI, 1.065-1.196).


CONCLUSIONS
Several factors that were independently associated with longer hospital stay in adult patients with CAP. These factors should be considered when evaluating the adequacy of the duration of hospitalization in a specific center and when designing future studies investigating new strategies to reduce the length of hospital stay.
Garcia-Vidal
Carolina
C
Servicio de Enfermedades Infecciosas, Hospital Universitari de Bellvitge, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Universitat de Barcelona, L'Hospitalet de Llobregat, Barcelona, España. carolgv75@hotmail.com
Carratalà
Jordi
J
Díaz
Violeta
V
Dorca
Jordi
J
Verdaguer
Ricard
R
Manresa
Frederic
F
Gudiol
Francesc
F
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000453:epidemiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D017714:Community-Acquired Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy; D015897:Comorbidity; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D007121:Immunocompetence; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000453:epidemiology / Q000209:etiology; D011014:Pneumonia / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012307:Risk Factors; D012772:Shock, Septic / Q000453:epidemiology / Q000209:etiology; D013030:Spain / Q000453:epidemiology
D000900:Anti-Bacterial Agents