[Factors associated with prolonged hospital stay in community-acquired pneumonia].

INTRODUCTION

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.