PREDICTORS OF PROLONGED HOSPITAL STAY AMONG CHILDREN AGED 3 MONTHS TO 14 YEARS ADMITTED WITH SEVERE PNEUMONIA AT ASELLA REFERRAL AND TEACHING HOSPITAL, SOUTHEAST ETHIOPIA, 2024/2025

Abstract

Abstract Background: Severe pneumonia is a leading cause of hospitalization and death among children under five, especially in low-income countries like Ethiopia.Various factors such as malnutrition, Anemia, Comorbidities, and delayed treatment are associated with prolonged hospital stay in children with severe pneumonia. Prolonged hospital stay increases health care costs, risks of hospital acquired infections, and resource burden on health systems. Objective: This study aimed to determine the magnitude of prolonged hospital stay and identify its predictors among pediatric patients admitted with severe pneumonia at Asella referral and teaching hospital, Arsi zone, southeast, Ethiopia from 2024 to 2025.

Methods: A hospital based retrospective cross-sectional study was conducted using secondary data analysis on pediatric patients with severe pneumonia. Data was entered into Microsoft Excel for data cleaning, coding, and preliminary processing, then exported to Statistical Package for Social Sciences (SPSS) version 27.0.1 for analysis. Bivariate logistic regression analysis at a significance level of 0.25 and multivariate logistic regression analyses with a significance level of 0.05 were conducted to determine the factors associated with prolonged hospital stay among pediatric patients.

Results: In this study 42% (95% CI: 37.21%- 46.81%) of patients with severe Pneumonia had prolonged hospital stays. The presence of underlying comorbidity (adjusted odds ratio [AOR]: 3.16, 95% CI: [1.832-5.336]), unvaccinated status (AOR: 2.01, 95% CI [1.694-3.815]), Malnutrition (AOR: 2.94,95% CI [1.383-6.290]),having history of previous pneumonia (AOR: 3.277, 95% CI [1.798-5.971]) and delayed in seeking health care provider( AOR: 3.773; CI [2.037-6.989] were independent predictors of prolonged hospital stay among pediatric patients with severe pneumonia. Conclusion: In this study, more than one-third of pediatric patients with severe pneumonia had a length of stay of more than 5 days, and not vaccination status, malnutrition, previous history of pneumonia, delayed health care seeking, and underlying comorbidities were independent predictors of prolonged hospital stay. Therefore, healthcare providers, parents, and other stakeholders should work to improve vaccination rate, improve community early health care seeking behavior through education, and inpatient management of malnutrition and other comorbid diseases to reduce hospital stays for pediatric patients with severe pneumonia.

Key words: pediatric patients, prolonged hospital stay, severe pneumonia, southeast Ethiopia