Factor Analysis of Prolonged Hospital Stay of Elderly Patients with Community-Acquired Pneumonia

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To analyze the factors involved in prolonged hospital stay of elderly patients (over 60 Years old) with community acquired pneumonia (CAP), the elderly patients with pneumonia managed at K Clinic (a 19-bed clinic) were investigated as to : (1) the age, (2) underlying disease, (3) mobility at the time of admission, (4) severity of pneumonia, (5) tests and treatment, and (6) length of hospital stay. The tests and treatment for pneumonia at the K Clinic follow standardized guidelines. The patient is discharged when the clinical signs of inflammation and the radioopacity on the chest radiograph have resolved.Of the 30 elderly patients with CAP who were thus investigated, 20 had no underlying disease (Group A). The mean length of hospital stay for these patients was about 10 days(the mean age was 72.8 years). The severity of pneumonia, as evaluated based on the extent of radioopacity on the chest radiograph and the physical findings, was rated as mild in 17 patients and moderate in the remaining 3 patients from Group A. Ten of the total of 30 patients examined had some chronic underlying disease, and these patients were assigned to Group B. The mean length of hospital stay in this group was 17 days, and the mean age was 71.2 years. The severity of pneumonia was rated as mild in all the patients of this group. When mobility at the time of admission was evaluated, all the patients from both Groups A and B could walk unassisted. The finding that the mean length of hospital stay was significantly shorter in Group A than in Group B indicates that prolonged hospital stay of elderly patients with CAP is associated with the presence of underlying chronic disease. This is consistent with the observation of Fine et al.(1993).