Clinical Predictors of Prolonged Hospitalization in Children with Community-Acquired Pneumonia

<b>Objectives:</b> This study aimed to identify key predictors of prolonged hospitalization in children with community-acquired pneumonia by comparing demographic and clinical characteristics between patients with expected and extended hospital stays. <b>Methods:</b> A retrospective cohort study was conducted for children younger than 15 years hospitalized with pneumonia between May 2015 and March 2020. Patients with hospital-acquired pneumonia or additional diagnoses were excluded. Demographic and clinical variables were collected. Statistical analysis, including logistic regression, was performed using SPSS v28 to identify independent predictors of prolonged hospitalization. <b>Results:</b> A total of 455 pediatric patients were included, with a median age of 2 years and a median length of stay of 6 days. Prolonged hospitalization occurred in 27.5% (<i>n</i> = 125) of cases. Gender distribution did not differ significantly between groups (<i>p</i> = 0.727). Significant predictors of prolonged hospitalization included moderate-to-severe pneumonia (<i>p</i> < 0.001, OR = 9.7, 95% CI = 3.1-30.9), pneumonia complications (<i>p</i> = 0.019, OR = 15.16, 95% CI = 1.57-146.3), and underlying chronic conditions (<i>p</i> = 0.009, OR = 2.88, 95% CI = 1.3-6.4). While hypoxia, ventilatory support, and bacteremia were associated with prolonged stay, they did not emerge as independent predictors in the final multivariable model. <b>Conclusion:</b> Prolonged hospitalization in pediatric pneumonia is strongly associated with increased disease severity, complications, and chronic comorbidities. Early identification of high-risk patients may facilitate targeted management strategies, improve outcomes, and reduce healthcare burden.