FACTORS ASSOCIATED WITH PROLONGED LENGTH OF STAY IN PATIENTS WITH CONCURRENT RESPIRATORY AND GASTROINTESTINAL DISORDERS

Abstract

Objective: To identify the clinical predictors of extended hospitalization among adult patients admitted with concurrent respiratory and gastrointestinal illnesses at a tertiary care hospital in Pakistan. Methods: This analytical cross-sectional study was conducted in the Department of Pulmonology at a tertiary care teaching hospital in Pakistan from August 2025 to January 2026. A total of 385 patients aged 18–70 years with coexisting respiratory and gastrointestinal illnesses were enrolled using a non-probability consecutive sampling technique. Demographic, clinical, laboratory, and hospitalization-related data were collected using a structured proforma. Respiratory illnesses included pneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD), acute bronchitis, and asthma exacerbation, whereas gastrointestinal manifestations included diarrhea, vomiting, abdominal pain, and dehydration. Extended hospitalization was defined as a hospital stay exceeding six days. Data were analyzed using SPSS version 26.0. Results: Prolonged hospitalization occurred in 97 (25.2%) patients. Pneumonia (41.8%) and acute exacerbation of COPD (31.7%) were the predominant respiratory diagnoses, while diarrhea (61.8%) and vomiting (48.3%) were the most common gastrointestinal manifestations. Multivariable analysis identified age above 60 years, diabetes mellitus, oxygen saturation below 92%, moderate-to-severe dehydration, oxygen therapy requirement, and ICU admission as independent predictors of extended hospitalization. Conclusion: Prolonged hospitalization was common among adults with concurrent respiratory and gastrointestinal illnesses and was primarily associated with markers of respiratory compromise and systemic illness severity. Early identification of high-risk patients may improve outcomes and optimize healthcare resource utilization.