Predictors of Prolonged Hospitalization in Pediatric Asthma Exacerbations: A Retrospective Study from Jordan

Introduction: This study aimed to identify the predictors of prolonged hospitalization (>3 days) among children admitted with acute asthma. Methods: A retrospective observational study of children aged 2–18 years was conducted at Jordan University Hospital between September 2019 and September 2022. Demographic data, clinical history, imaging, and treatment information were extracted from medical records. Logistic regression was used to estimate the adjusted odds ratio (AOR) with a 95% confidence interval to investigate factors associated with a hospital stay longer than 3 days. Results: In 284 patients (average age 8.0 years; 62.3% male), 44.8% of hospital stays lasted for more than 3 days. Independent predictors of prolonged stay included preceding upper respiratory tract infection (AOR 2.27, 95% CI 1.20–4.27), CPAP requirement (AOR 5.66, 95% CI 2.47– 12.95), and antibiotic administration (AOR 2.55, 95% CI 1.18–5.51). Discussion: These findings highlight the effect of preceding infection and treatment intensity on the duration of hospitalization, underlining the importance of early infection management, timely escalation of respiratory support, and antimicrobial stewardship. Conclusion: Children with preceding infections, CPAP requirements, and antibiotic therapy were more likely to be hospitalized for a longer time. Targeted interventions can reduce the length of stay and optimize patient care.