Predictors of Prolonged Hospitalization in Patients with Fever

Shoab Saadat

doi:10.7759/cureus.789

Abstract

Objective: The study was conducted to analyze the predictors of prolonged hospitalization in patients with fever.Patients and Methods: This was a prospective cohort study conducted from July - December 2015 at Ayub Teaching Hospital, Pakistan. Convenience sampling was used to enroll the patients who visited the hospital during the study duration. A sample size of 115 patients was calculated. It included patients who presented with a new onset fever which started in the last month, and the cause of fever was undiagnosed at the time of admission. Critical patients were excluded. Data for more than 30 variables was collected on a pro forma. Univariate regression methods were used to analyze the data in the Statistical Package for Social Sciences (SPSS), version 23.Results: A total of 115 patients were analyzed. Males constituted 66/115 (57.4%). The mean age for patients was 43.6 years (standard deviation (SD) = 20.2). On admission, low platelet counts (p = 0.001), high erythrocyte sedimentation rate (ESR) counts (p = 0.007), a high total leukocyte count (TLC) (p = 0.029), and involvement of nervous (p = 0.021), cardiovascular (p = 0.04), respiratory (p = 0.043), gastroenterological (p = 0.042), hematological (p = 0.028), or urogenital system (p = 0.016) were associated with a longer stay in the hospital.Conclusion: Patients with an undiagnosed and new onset fever will have a longer hospital stay if, on admission, they have low platelet counts, a higher ESR, a high TLC, or involvement of nervous, cardiovascular, respiratory, gastrointestinal, hematological, or urogenital systems. An early identification of risk factors can lead to better treatment and may also lead to a decreased hospital stay.

Highlights

A large number of patients are admitted all over the world who present with an undiagnosed and new onset fever, most of them are found to have an infectious etiology, followed by autoimmune causes [1]
All the patients with a history of new onset fever measured to be greater than 98° Fahrenheit that had started within the previous month and who had remained undiagnosed at the time of admission, had not been to any other facility, and were a candidate for admission were analyzed
No one tested positive for Brucella antibodies or for a polymerase chain reaction (PCR) test for the dengue fever

Summary

Introduction

A large number of patients are admitted all over the world who present with an undiagnosed and new onset fever, most of them are found to have an infectious etiology, followed by autoimmune causes [1]. All this is coupled with the fact that prolonged hospitalizations are associated with a greater incidence of hospital-acquired infections, which in turn can lead to an even longer hospital stay [4]. This assumption is true for both the infective and non-infective causes of undiagnosed fever [5]

Methods

Results

Conclusion