Journal Article

Prognostic factors associated with length of stay in children with an acute admission to a pediatric ward: a historical cohort study

Maaskant, Jolanda M., Timmer, Karlijn S., Bijlsma, Merijn W., Voskuijl, Wieger P.

2025

Overview

Background An acute (i.e. unplanned) admission implies uncertainty about the length of stay (LOS) for children, their parents and hospital staff. An improved understanding of the prognostic factors associated with LOS in children is essential for adequate discharge planning, optimal use of bed capacity, and patient counseling. We aimed to explore which prognostic factors were associated with LOS in children between 0 and 18 years old, who were acutely admitted to a pediatric academic hospital ward. Methods We conducted a historical cohort study using electronic data from all children who were acutely admitted to the Emma Children’s Hospital, the Netherlands, between 2017 and 2022. Selection of potential prognostic factors was based on literature and expert opinion. Univariable linear regression analysis was used to select prognostic factors associated with LOS, followed by multivariable regression analysis to obtain the final model. Results We included 9209 children with a median LOS of 2.7 days (IQR 1.1 to 5.8). Out of 16 potential prognostic factors, 10 were associated with an increased LOS, while 4 decreased the LOS. The strongest associations were (1) the involvement of ≥ 3 sub-specialties during the first 24 h of admission, (2) the severity of illness and (3) medical home care after discharge, and were all prognostic for an increased LOS. The final model explained 29% of the variance in LOS. Conclusions The results of this study support patient and hospital expectations and bed capacity management. The explained variance is limited despite the inclusion of multiple factors, suggesting predicting LOS for this population is challenging.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Acute disease / Admission and discharge / Adolescent / Child / Child, Preschool / Cohort analysis / Cohort Studies / Emergency medical care / Families & family life / Female / General ward / Hospital costs / Hospitalization / Hospitals / Hospitals, Pediatric - statistics & numerical data / Humans / Infant / Infant, Newborn / Intensive care / Internal Medicine / Length of stay / Length of Stay - statistics & numerical data / Male / Medicine / Medicine & Public Health / Missing data / Netherlands / Outpatient care facilities / Patient Admission - statistics & numerical data / Patient satisfaction / Pediatric research / Pediatrics / Physiological aspects / Prognosis / Prognostic factors / Regression analysis / Research data management / Unplanned admission / Variables