OPA15 PREDICTIVE FACTORS FOR LENGTH OF HOSPITAL STAY IN VIRAL PNEUMONIA: AN UNDERSTUDIED ADULT POPULATION IN MALAYSIA

Chee Kuan Wong1,2, Chia Xiang Lim1, Vijayan Munusamy2, Leng Cheng Sia2, Thian Chee Loh1,2, Chun Ian Soo1,2, Mau Ern Poh1.2
1Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
2Department of Medicine, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia

Introduction

Viral pneumonia is well-studied in the paediatric population due to its high prevalence, but its impact on Malaysian adult population is less understood. This study aims to identify factors associated with length of stay (LOS) in adult viral pneumonia patients in a Malaysian tertiary hospital. 

Methodology

This retrospective cross-sectional study involved adults aged 18 and above who were admitted from January 1, 2023, to December 31, 2023 with the diagnosis of community-acquired pneumonia (CAP). Patients with hospital-acquired pneumonia (HAP), aspiration pneumonia, tuberculosis (TB), and negative virological results were excluded. Data collected includes patients’ demographics, comorbidities, immunization and smoking status, length of stay (LOS), ICU admission, laboratory results, severity scores [CURB-65 and Pneumonia Severity Index (PSI)], treatments, and complications. Log transformation of LOS is used as it is not normally distributed. 

Results 

The study reviewed 149 patients with a median age of 68 years (IQR: 54-77). The overall median LOS was 6.0 days (IQR: 4.0-8.5), increasing with higher PSI classes [p<0.001, aOR 0.173 (95% CI: 0.096-0.250)].  Multiple regression analysis showed that LOS increased significantly (P <0.05) with interstitial lung disease [aOR 0.553 95% CI: 0.023-1.083], dementia [aOR 0.820 (95% CI: 0.290-1.350], ICU admission [aOR 0.301 (95% CI: 0.048-0.554], viral-bacterial co-infection [aOR 0.348 (95% CI: 0.124-0.572], and total number of complications [aOR 0.090 (95% CI: 0.024-0.156].

Conclusion 

This study identified several independent predictors of length of stay (LOS) in adult patients with viral pneumonia. We recommend using the PSI score over the CURB-65 score in cases of viral CAP to better estimate the LOS. Strategies such as vaccination in high-risk groups and early antibiotic initiation in suspected viral-bacteria co-infection may help in reducing the LOS in this group of patients.