Clinical Predictors of Extended ICU Stay and Their Role in Critical Care Resource Management : A Case-Control Study in Severe Viral Pneumonia

Background : Efficient use of ICU beds is essential, particularly during outbreaks of severe respiratory disease. Understanding which patients are likely to remain in ICU longer helps improve planning and optimize patient care pathways.

Objective: To identify clinical and epidemiological factors linked to extended ICU stay and explore their impact on resource planning.

Methods : We conducted a case-control study over six months (August 2020 – February 2021) in the ICU of HMMV Hospital.

Adult patients with severe viral pneumonia were included. Demographic data, comorbidities, CT lung involvement, need for mechanical ventilation (MV), and outcomes were analyzed.

Prolonged ICU stay was defined as more than five days. Logistic regression identified independent predictors.

Results: Among 300 patients (mean age 67 ± 11 years; 72.3% men), prolonged ICU stay was strongly associated with obesity (adjusted OR 6.25; 95% CI 2.56–15.3), diabetes (OR 2.55; 95% CI 1.34–4.85), malignancy (OR 4.00; 95% CI 1.14–13.69), and MV (OR 3.38; 95% CI 1.67–6.83).

Conclusion : Obesity, diabetes, malignancy, and mechanical ventilation significantly increase the likelihood of prolonged ICU stay.

These insights may support better bed management, improve resource allocation, and strengthen ICU preparedness for future surges.