Predictors of Prolonged Hospital Stay Among Patients Admitted to A General Medicine Ward: A Retrospective Cohort Study

Original Article

Abstract

Background: Prolonged hospital stay is a major challenge in general medicine wards, contributing to increased healthcare costs, hospital-acquired infections, delayed patient turnover, and poor clinical outcomes. Early identification of factors associated with extended hospitalization may facilitate timely interventions, optimize resource utilization, and improve discharge planning.

Objectives: To determine the demographic, clinical, and laboratory predictors of prolonged hospital stay among patients admitted to a general medicine ward.

Methods: This retrospective cohort study was conducted in the Department of Medicine, Jinnah Medical College, Peshawar between 1 January and 1 June 2025. Patients with incomplete records, hospital stay of less than 24 hours, discharge against medical advice, transfer to another healthcare facility, or repeat admissions were excluded. Demographic characteristics, comorbidities, laboratory parameters, intensive care unit (ICU) transfer, hospital-acquired infections, and duration of hospitalization were recorded using a standardized data collection form. Prolonged hospital stay was defined as hospitalization lasting more than seven days. Data were analyzed using SPSS version 27.0. Continuous variables were compared using the independent-samples t-test, categorical variables using the Chi-square test, and multivariable logistic regression was performed to identify independent predictors. A p-value <0.05 was considered statistically significant.

Results: Of the 100 patients included, 36 (36%) experienced a prolonged hospital stay (>7 days). Univariate analysis showed that advanced age, diabetes mellitus, chronic kidney disease (CKD), hypoalbuminemia, hospital-acquired infections, and ICU transfer were significantly associated with prolonged hospitalization (p<0.05). Multivariable logistic regression identified hypoalbuminemia, CKD, and hospital-acquired infections as independent predictors of prolonged hospital stay after adjustment for potential confounding factors.

Conclusion: More than one-third of hospitalized general medicine patients experienced prolonged hospital stay. Hypoalbuminemia, chronic kidney disease, and hospital-acquired infections were independent predictors of extended hospitalization. Early identification and targeted management of these modifiable risk factors may reduce hospital stay, improve patient outcomes, and enhance healthcare resource utilization.