Factors associated with Length of Hospital Stay among Under-Five Children Admitted with Severe Acute Malnutrition in St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia

Abstract

Background: Prolonged hospitalization among children with severe acute malnutrition remains a significant chal­lenge in Ethiopia. While most of these children receive hospital treatment, a substantial proportion experience ex­tended hospital stays. However, there is a paucity of research on the determinants of prolonged hospitalization in this context. Therefore, this study aimed to determine the average length of hospital stay and its determinants among children who recovered from SAM at St. Paul’s Hospital Millennium Medical College (SPHMMC), Addis Ababa, Ethiopia.  

Methods: An institution-based cross-sectional study was among 466 under-five children admitted to St. Paul’s Hospital Millennium Medical College from 2012 to 2019. A retrospective document review was carried out using a standardized data ex­traction tool. A multiple linear regression model was employed to identify factors associated with length of stay. A Backward stepwise variable selection was employed to determine the final model. The coefficient of determination (R2) was used to assess the model's adequacy, and residual analysis verified the fundamental assumptions of the model.

Results: This study included 466 children aged between 1 and 59 months. The average duration of stay for children in this study was 19.27 +11.67 days. The main determinants of length of hospital stay were hemoglobin level (β=-0.62, p=6.5E-03), tuberculosis (β=9.05, p=6.1E-09), hospital-acquired infections (β=7.96, p=5.5E-07), meningitis (β=8.38, p=5.4E-03), rickets (β=2.58, p=3.9E-02), hyponatremia (β=9.14, p=4.8E-02) and no impaired level of con­sciousness (β=-5.04, p=2.4E-02). The coefficient of determination (R2) was found to be 26%.

Conclusion: The typical length of hospital stays for children with SAM fell within the suggested range established by Sphere. However, many children, particularly those with comorbidities including tuberculosis, meningitis, nosocomial infections, and rickets, ended up spending a prolonged time in the hospital. Therefore, promptly treating comorbidities could decrease the duration of hospital stays for children with SAM.