Clinical Profile and Predictors of Prolonged Hospital Stay Among Patients Admitted with Acute Febrile Illness in Southern Rajasthan: A Retrospective Observational Study
DOI:
https://doi.org/10.69980/ajpr.v27i2.922Keywords:
acute febrile illness, prolonged hospital stay, dengue, malaria, enteric fever, Rajasthan, predictors, tropical feverAbstract
Background: Acute febrile illness (AFI) constitutes one of the leading causes of hospitalisation in tropical countries, accounting for substantial morbidity and ICU utilisation across tertiary care institutions in India. Southern Rajasthan, with its ecological diversity encompassing forest fringes, agricultural land, and tribal belts, harbours endemic foci of dengue, malaria, enteric fever, scrub typhus, and leptospirosis. Despite the regional burden, local data on the clinical profile and determinants of prolonged hospital stay (PHS) among AFI admissions are lacking from this geography.
Objectives: To describe the clinical and aetiological profile of adult patients admitted with acute febrile illness and to identify independent clinical and laboratory predictors of prolonged hospital stay (>7 days) at Pacific Institute of Medical Sciences (PIMS), Umarda, Udaipur.
Methodology: A retrospective observational study of 280 consecutive adult patients (≥18 years) admitted with AFI from January 2023 to December 2023 was conducted. Case records were reviewed for demographic data, clinical features, laboratory parameters, aetiology, and duration of hospitalisation. Prolonged hospital stay was defined as inpatient duration >7 days. Univariate and multivariate binary logistic regression using SPSS v25 identified independent predictors.
Results: Of 280 patients (mean age 38.6 ± 14.4 years, 61.1% male), 82 (29.3%) experienced prolonged hospital stay (>7 days). The most common aetiologies were dengue (36.4%), enteric fever (21.8%), malaria (16.1%), scrub typhus (9.3%), and leptospirosis (5.0%). Thrombocytopenia (platelet <50,000/mm³; OR 4.63, 95% CI 2.41–8.91, p<0.001), presence of comorbidities (OR 3.87, 95% CI 1.98–7.57, p<0.001), haemoglobin <8 g/dL (OR 3.21, 95% CI 1.57–6.57, p=0.001), serum creatinine >1.5 mg/dL (OR 2.94, 95% CI 1.44–6.00, p=0.003), and hepatic dysfunction (ALT >3× ULN; OR 2.71, 95% CI 1.38–5.33, p=0.004) were independent predictors of prolonged stay on multivariate analysis.
Conclusion: Thrombocytopenia, comorbidities, anaemia, renal impairment, and hepatic dysfunction independently predicted prolonged hospital stay in AFI patients at this southern Rajasthan tertiary centre. Early risk stratification using these parameters can facilitate timely escalation of care, optimise resource allocation, and potentially reduce inpatient duration.
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