Factors associated with prolonged hospitalization among under-five children with community-acquired pneumonia: A cross-sectional observational study.

Snehasini Dash; Suvendu Kumar Panda; Dhurjati Prasad Mahapatra; Pragnya Padhy; Soubhagya Mayee Sahoo; Srikanta Panigrahy

doi:10.51168/gqe29q55

Authors

Dr. Snehasini Dash Assistant Professor, Department of Pharmacology, DRIEMS Institute of Health Sciences and Hospital, Cuttack, Odisha
Dr. Suvendu Kumar Panda Assistant Professor, Department of Pharmacology, MKCG, Medical College and Hospital, Berhampur, Odisha
Dr. Dhurjati Prasad Mahapatra MBBS, MD (General Medicine), Consultant OMHS Cadre, Govt. Of Odisha
Dr. Pragnya Padhy Post Graduate Trainee, 3rd year, Department of Pharmacology, VIMSAR, Burla, Odisha
Dr. Soubhagya Mayee Sahoo Post PG Senior Resident, Department of Pharmacology, MKCG Medical College and Hospital, Berhampur, Odisha
Dr. Srikanta Panigrahy Senior Resident, Department of Pharmacology, MKCG Medical College and Hospital, Berhampur

DOI:

https://doi.org/10.51168/gqe29q55

Keywords:

Community-acquired pneumonia, Under-five children, Prolonged hospitalization, Length of hospital stay, Malnutrition, Breastfeeding, Anemia, Leukocytosis, Risk factors

Abstract

Background:

Prolonged hospitalization among under-five children with community-acquired pneumonia (CAP) increases healthcare utilization and socioeconomic burden.

Objective:

To assess sociodemographic, nutritional, environmental, clinical, laboratory, treatment-related, and adverse drug reaction (ADR)-related factors associated with prolonged hospitalization among under-five children with CAP.

Methods:

A hospital-based cross-sectional observational study was conducted in the Department of Paediatrics in collaboration with the Department of Pharmacology and Therapeutics, M.K.C.G. Medical College and Hospital, Berhampur, Odisha, India, from August 2023 to September 2024. A total of 118 children aged 2–59 months with CAP were enrolled consecutively. Hospitalization >7 days was considered prolonged. Categorical variables were analysed using Pearson’s chi-square and Fisher’s exact tests, as applicable. Associations were expressed as unadjusted odds ratios (ORs) with 95% confidence intervals (CIs).

Results:

Of 118 children, 44 (37.3%) experienced prolonged hospitalization. Higher family income was associated with lower odds of prolonged stay (OR=0.294; 95% CI: 0.115–0.746), whereas larger household size increased the odds (OR=2.465; 95% CI: 1.127–5.394). Breastfeeding (OR=0.176; 95% CI: 0.034–0.914), hand hygiene (OR=0.352; 95% CI: 0.155–0.799), and toilet use (OR=0.316; 95% CI: 0.139–0.717) were protective, while malnutrition (OR=2.174; 95% CI: 1.010–4.673), grunting (OR=3.300; 95% CI: 1.148–9.488), abdominal pain (OR=11.526; 95% CI: 1.339–99.253), and TLC >15 (OR=4.181; 95% CI: 1.887–9.266) were associated with prolonged hospitalization. Hemoglobin >10 was protective (OR=0.250; 95% CI: 0.108–0.579). ADR status was not significantly associated with prolonged hospitalization (p=0.931).

Conclusion:

Prolonged hospitalization was associated with socioeconomic, nutritional, clinical, and laboratory factors.

Recommendation:

Early identification of these factors may facilitate risk stratification, closer monitoring, nutritional support, and appropriate clinical management to reduce prolonged hospitalization.

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