Factors Associated with Length of Hospital Stay and Clinical Characteristics of Children Hospitalized with Measles

Objective: To evaluate the clinical characteristics, complications, and factors associated with the length of hospital stay in children hospitalized with measles. Materials and Methods: This retrospective, observational study included children aged 0-18 years hospitalized with measles between January and December 2023 at a tertiary care center in Istanbul, Türkiye. Demographic, clinical, laboratory, and hospitalization data were analyzed. Results: Sixty-one hospitalized children with measles were included; 32 (52.5%) were younger than 5 years and 29 (47.5%) were older than 5 years. Fifty-nine percent were Turkish citizens, 41% were foreign nationals, and 57.4% were male. Overall, 77% were unvaccinated. Fever and rash were present in all patients. Pneumonia was the most common complication (68.9%), followed by hepatitis (11.5%), gingivostomatitis (11.5%), ocular complications (9.8%), and otitis (4.9%). All hepatitis cases occurred in children older than 5 years. Three patients (5.2%) required pediatric intensive care. In univariable linear regression analyses, pneumonia/bronchopneumonia, C-reactive protein (CRP), and white blood cell count were significantly associated with longer hospital stay. In the primary multivariable linear regression model, only CRP remained independently associated with prolonged hospitalization (B = 0.017, 95% CI = 0.0002-0.0333; P = .047). No measles-related deaths occurred. Conclusion: Measles remains a major public health problem, particularly among unvaccinated children. Inflammatory markers were associated with prolonged hospitalization, suggesting that systemic inflammation may contribute to longer inpatient care. Larger multicenter studies are needed to confirm these findings.