Factors Affecting the Length of Hospital Stay in Patients with Parapneumonic Effusion Undergoing Conservative Treatment

Introduction: Parapneumonic effusion (PPE) is a common complication of community-acquired pneumonia in children, often requiring hospitalization and varying treatment approaches. This study aimed to identify the factors influencing the length of hospital stay in pediatric patients with PPE managed conservatively.Methods: This retrospective cross-sectional study analyzed pediatric patients diagnosed with PPE and hospitalized between January 1, 2017, and December 31, 2021. Clinical, laboratory, radiological, and treatment data were reviewed to evaluate the factors associated with the length of hospital stay in conservatively managed cases.Results: The study included 90 patients, with a median age of 6.7 years; 55.6% were female and 64.4% were older than 5 years. The most common symptoms were cough (87.8%) and fever (83.3%), and the median length of hospital stay (LOS) was 21 days. Patients under 5 years of age, those requiring respiratory support, and those needing a change in antibiotic therapy (ABT) had significantly longer LOS. LOS was shorter in patients receiving ABT alone compared with those who also underwent chest tube drainage, and early fibrinolytic treatment (within the first week) was associated with shorter LOS compared with delayed (>2 weeks) administration.Conclusions: Early chest tube drainage, especially in children under five years of age, may help reduce the LOS in conservatively managed PPE cases. Prospective studies are needed to confirm these findings and support clinical decision-making in pediatric PPE management.