Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, POB: 196, Gondar, Ethiopia.
Department of Health Service Management and Health Economics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, POB: 196, Gondar, Ethiopia.
BMC Public Health. 2020 Aug 8;20(1):1217. doi: 10.1186/s12889-020-09324-x.
The length of hospital stay is the duration of hospitalization, which reflects disease severity and resource utilization indirectly. Generally, tuberculosis is considered an ambulatory disease that could be treated at DOTs clinics; however, admission remains an essential component for patients' clinical stabilization. Hence, this study aimed to identify factors influencing hospital stay length during the intensive phase of multidrug-resistant tuberculosis treatment.
A retrospective follow-up study was conducted at three hospitals, namely the University of Gondar comprehensive specialized, Borumeda, and Debremarkos referral hospitals from September 2010 to December 2016 (n = 432). Data extracted from hospital admission/discharge logbooks and individual patient medical charts. A binary logistic regression analysis was used to identify factors associated with more extended hospital stays during the intensive phase of multidrug-resistant tuberculosis treatment.
Most patients (93.5%) had a pulmonary form of multidrug-resistant tuberculosis and 26.2% had /TB/HIV co-infections. The median length of hospital stays was 62 (interquartile range from 36 to 100) days. The pulmonary form of tuberculosis (Adjusted odds ratio [AOR], 3.47, 95% confidence interval [CI]; 1.31 to 9.16), bedridden functional status (AOR = 2.88, 95%CI; 1.29 to 6.43), and adverse drug effects (AOR = 2.11, 95%CI; 1.35 to 3.30) were factors associated with extended hospital stays.
This study revealed that the length of hospital-stay differed significantly between the hospitals. The pulmonary form of tuberculosis decreased functional status at admission and reported adverse drug reactions were determinants of more extended hospital stays. These underscore the importance of early case detection and prompt treatment of adverse drug effects.
住院时间是指住院的持续时间，它间接反映了疾病的严重程度和资源的利用情况。一般来说，结核病被认为是一种可以在 DOTs 诊所治疗的门诊疾病；然而，住院仍然是患者临床稳定的重要组成部分。因此，本研究旨在确定影响耐多药结核病强化治疗期间住院时间长短的因素。
本研究是一项回顾性随访研究，在 2010 年 9 月至 2016 年 12 月期间，在 3 家医院（贡德尔大学综合专科医院、博鲁梅达和德布雷马科斯转诊医院）进行（n=432）。从入院/出院日志和患者个人病历中提取数据。采用二元逻辑回归分析确定与耐多药结核病强化治疗期间延长住院时间相关的因素。
大多数患者（93.5%）患有肺型耐多药结核病，26.2%合并 /TB/HIV 感染。住院时间中位数为 62 天（四分位距 36 至 100 天）。肺结核肺型（调整后的优势比 [AOR]，3.47，95%置信区间 [CI]；1.31 至 9.16）、卧床不起的功能状态（AOR=2.88，95%CI；1.29 至 6.43）和药物不良反应（AOR=2.11，95%CI；1.35 至 3.30）是与延长住院时间相关的因素。
本研究表明，医院之间的住院时间差异显著。肺结核肺型降低了入院时的功能状态，报告的药物不良反应是延长住院时间的决定因素。这些突出表明早期发现病例和及时处理药物不良反应的重要性。
