Determinants of Hospital Length of Stay in Herpes Zoster Patients: A Four-Year Retrospective Study

The Varicella-zoster virus (VZV) primarily causes chickenpox and can later reactivate as herpes zoster (HZ) from latent VZV in sensory ganglia. HZ generally presents with unilateral dermatomal pain and vesicular skin eruptions. Immunosuppression, advanced age, and underlying comorbidities increase the risk of severity, hospitalization, and longer length of stay (LOS), adding a substantial burden to the healthcare system. In this study, we examined factors influencing LOS in hospitalized HZ patients.

We aimed to identify factors contributing to prolonged LOS in hospitalized patients with confirmed HZ at a tertiary referral center in southwestern Iran, from March 2020 to September 2024. We performed statistical analyses to explore the relationships between demographics, clinical features, comorbidities, medications, and laboratory findings (ESR, CRP) with LOS.

Of the 109 hospitalized HZ patients (50.5% female), the mean LOS was 6.1 ± 5.2 days. LOS showed significant correlations with elevated ESR (r = 0.304, p = 0.006), severe complications like encephalitis and Ramsay Hunt Syndrome (p < 0.001), and pre-existing neurological and renal conditions (p < 0.05). No links were observed with age, CRP levels, gender, or immunosuppressant drug use.

Severe neurological complications such as encephalitis and Ramsay Hunt syndrome, along with specific comorbidities and high ESR, notably extend hospital stays for HZ patients. These findings highlight the burden of severe HZ and identify key factors affecting LOS. By quantifying these elements, we provide practical insights to optimize inpatient care and emphasize the importance of prevention in high-risk populations.