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Clinical Predictors of Prolonged Hospitalization in Children with Community-Acquired Pneumonia

Nasser S Alharbi1,2, Fahad Alsohime1,2, Waleed Abdulla Alharthi3

  • 1Department of Pediatrics, College of Medicine, King Saud University, Riyadh 11451, Saudi Arabia.

Children (Basel, Switzerland)
|February 27, 2026
PubMed

Insights

Severe community-acquired pneumonia, complications, and chronic conditions predict prolonged hospital stays in children. Identifying these risk factors can improve pediatric pneumonia patient outcomes and reduce healthcare costs.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Public Health

Background:

  • Community-acquired pneumonia (CAP) is a leading cause of pediatric hospitalization worldwide.
  • Prolonged hospital stays for CAP contribute significantly to healthcare costs and resource utilization.
  • Predictors of extended hospitalization in pediatric CAP require further elucidation to optimize patient management.

Purpose of the Study:

  • To identify key demographic and clinical predictors of prolonged hospitalization in children diagnosed with community-acquired pneumonia.
  • To compare characteristics between pediatric patients with expected versus extended hospital stays for pneumonia.

Main Methods:

  • Retrospective cohort study of pediatric patients (<15 years) hospitalized with pneumonia (May 2015-March 2020).
  • Exclusion of hospital-acquired pneumonia and patients with additional diagnoses.
  • Logistic regression analysis to determine independent predictors of prolonged hospitalization.

Main Results:

  • 27.5% of 455 pediatric pneumonia patients experienced prolonged hospitalization (median stay: 6 days).
  • Significant independent predictors of prolonged stay included moderate-to-severe pneumonia (OR=9.7), pneumonia complications (OR=15.16), and underlying chronic conditions (OR=2.88).
  • Hypoxia, ventilatory support, and bacteremia were associated but not independent predictors in the final model.

Conclusions:

  • Pediatric community-acquired pneumonia patients with severe disease, complications, or chronic comorbidities are at higher risk for prolonged hospitalization.
  • Early identification of high-risk pediatric patients is crucial for implementing targeted management strategies.
  • Optimizing care for high-risk children can lead to improved outcomes and reduced healthcare burden.

Keywords:
empyemalength of staypneumonia

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