Predictors of Prolonged Hospitalization in Patients with Fever

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.

Fiebre y sus implicaciones en el diagnóstico del paciente neurológico, revisión narrativa de la literatura

“…La fiebre se genera como una respuesta adaptativa provocada, en la gran mayoría de las ocasiones, por microrganismos, aun cuando también participan respuestas hormonales, autoinmunes y a veces medicamentosas, que generan complejos cambios neuroquímicos y metabólicos que en principio buscan controlar la agresión, brindando un efecto protector (11,12). Algunas condiciones, como los tumores cerebrales, la hemorragia subaracnoidea (HSA), la hemorragia intraventricular y el vasoespasmo se han asociado con el desarrollo de fiebre de origen central (14)(15)(16). Figura 1.…”

Aetiologies and Risk Factors of Prolonged Fever Admission in Samtse Hospital, Bhutan, 2020

“…Many preventable deaths occur in low-and middle-income countries because of incorrect or delayed diagnosis, largely due to limited diagnostic and treatment facilities [3]. Cases of fever for prolonged duration without a known aetiology present a challenge for both the physicians and the patients, often leading to prolonged length of hospitalisation [10]. Prolonged hospital stay is associated with poor health outcomes, increased risk of mortality [11], substantial economic burden and a huge psychological impact on the patients and their families [12,13].…”