Initial risk class and length of hospital stay in community-acquired pneumonia

The total medical costs of community-acquired pneumonia are directly. relat ed to the costs of hospital admission and length of stay. The aim of the pr esent study was to evaluate the reasons for prolonged duration of stay in p atients stratified in five risk classes for death, and to identify factors associated with prolonged stay. The study population consisted of 295 patients. According to lower (classes I, II, III) or to higher (classes IV, V) risk, the target duration of hosp italization was set at 5 and 7 days, respectively. The causes of prolonged hospitalization were classified as pneumonia-related, complications, unstab le comorbid diseases and nonclinical factors. The overall percentage of patients with appropriate duration of hospitaliza tion was set at 5 and 7 days respectively. The causes of prolonged hospital ization were related mainly to pneumonia (32%) from all risk classes. Morbi d complications and instability of the underlying illness were greater in c lass V patients. Nonclinical factors were present in 29.5%,, of cases. Hypo xaemia, anaemia, hypoalbuminaemia, and complications appearing before 72 h were associated with prolonged hospitalization. The cause of prolonged hospitalization of patients with community-acquired pneumonia is multifactorial, depending mainly on pneumonia and comorbid con ditions but there is a large number of unnecessary hospitalization days tha t could be reduced by improving the efficiency of hospital care.