Influencing factors for length of hospital stay in children with community-acquired pneumonia
JIN Biqing,GU Haoxiang,WU Beirong,DING Guodong
(Department of Respiratory Medicine, Shanghai Children’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200062, China)
Objective To investigate the factors influencing the length of hospital stay in children with community-acquired pneumonia(CAP). Methods The clinical data of 942 children with CAP admitted to the Shanghai Children’s Hospital from August 2018 to July 2019 were retrospectively analyzed. The length of stay was ≤7 d in 441 cases and >7 d in 501 cases. The associations of demographic characteristics, laboratory and radiographic findings at admission, days of fever, and pathogens of infection with the length of hospital stay were examined by univariate and multivariate logistic regression analysis. Results There were significant differences in age, infection sites by radiograph, pathogens of infection, days of fever, and white blood cell count(WBC), neutrophil percentage(NEUT), eosinophils(EOS), C-reactive protein(CRP), procalcitonin(PCT), erythrocyte sedimentation rate(ESR), creatine kinase-isoenzyme MB(CK-MB), lactate dehydrogenase(LDH), blood urea nitrogen(BUN) and serum creatinine(Scr) between the two groups(all P<0.05). Multivariate logistic regression analysis showed that multiple infection sites, co-pathogenic infections, more days of fever, and elevated NEUT, CRP, and ESR were independent risk factors for the length of hospital stay >7 d in children with CAP. The areas under the ROC curve(AUC) of fever days, NEUT, CRP, and ESR for predicting length of stay >7 days was 0.69(95%CI: 0.65-0.72, P<0.01), 0.63(95%CI: 0.59-0.66, P<0.01), 0.63(95%CI: 0.59-0.66, P<0.01), 0.60(95%CI: 0.56-0.63, P<0.01), and 0.60(95%CI: 0.56-0.63, P<0.01), respectively. Conclusion The number of fever days, and the NEUT, CRP, PCT, ESR, LDH, Scr levels at admission are positively correlated with the length of hospital stay in children with CAP. However, fever days, NEUT, CRP, and ESR are not effective indicators for predicting the length of stay.