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Factors impacting on length of stay of community acquired pneumonia

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Author:
LIU Hui(Department of Internal Medicine,Division of Pulmonary and Critical Care,Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China)
ZHANG Tian-tuo(Department of Internal Medicine,Division of Pulmonary and Critical Care,Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China)
WU Ben-quan(Department of Internal Medicine,Division of Pulmonary and Critical Care,Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China)
HUANG Jing(Department of Internal Medicine,Division of Pulmonary and Critical Care,Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China)
LI Hong-tao(Department of Internal Medicine,Division of Pulmonary and Critical Care,Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China)
ZHOU Yu-qi(Department of Internal Medicine,Division of Pulmonary and Critical Care,Third Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510630,China)
ZHU Jia-xin()
Journal Title:
CHINA MEDICINE
Issue:
Volume 5, Issue 02, 2010
DOI:
10.3760/cma.j.issn.1673-4777.2010.02.006
Key Word:
Community-acquired pneumonia;Length of stay;Risk class

Abstract: Objectives To evaluate the causes of prolonged length of stay in patients with community-ac-quired pneumonia(CAP) based on Fine risk classes. Methods A retrospective cohort analysis was performed for adult patients hospitalized with CAP between January 2002 and January 2006. According to low (classes Ⅰ, Ⅱ,Ⅲ) or high(classes Ⅳ, Ⅴ) risks, the target duration of hospitalization was set up as 7 and 9 days, respectively. Results A total of 302 patients were enrolled with a mean length of stay days of 10.5 days (range 2-47 days). 111 cases(36.8% ) were in Ⅰ-Ⅲ risk class(low risk class) and 191 (63.2%) were in Ⅳ-Ⅴ risk class(high risk class). Causes of prolonged hospitalization were related mainly to pneumonia (30%) in all risk classes. Morbid complications and instability of the underlying diseases were more in high risk class patients than those in low risk class. Nonclinical factors were more common in low risk class patient than those in high risk class. Conclusions The causes of prolonged hospitalization of patients with CAP are multifactorial, depending mainly on pneumonia and comorbid conditions. There is unnecessary hospitalization that could be reduced by improving the efficiency of hospi-tal care.

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