Risk factors on length of stay among pulmonary tuberculosis patients: A systematic review and meta-analysis

Background: Pulmonary Tuberculosis (PTB) remains a pressing public health concern. Long hospital stays for PTB patients can overburden both patients and healthcare systems. Objective: To identify the key factors contributing to extended length of stay in PTB patients. Information sources: Four elect...

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Main Authors: Dao Weiangkham, Adinat Umnuaypornlert, Surasak Saokaew, Neeranuch Wongcharoen, Samrerng Prommongkol, Jutamas Ponmark
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:International Journal of Nursing Studies Advances
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666142X25000268
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author Dao Weiangkham
Adinat Umnuaypornlert
Surasak Saokaew
Neeranuch Wongcharoen
Samrerng Prommongkol
Jutamas Ponmark
author_facet Dao Weiangkham
Adinat Umnuaypornlert
Surasak Saokaew
Neeranuch Wongcharoen
Samrerng Prommongkol
Jutamas Ponmark
author_sort Dao Weiangkham
collection DOAJ
description Background: Pulmonary Tuberculosis (PTB) remains a pressing public health concern. Long hospital stays for PTB patients can overburden both patients and healthcare systems. Objective: To identify the key factors contributing to extended length of stay in PTB patients. Information sources: Four electronic databases (PubMed, Scopus, Embase, and CINAHL) were systematically searched from inception to January 1, 2023. Methods: The articles were screened and performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Inclusion criteria were PTB patients diagnosed by doctors and studies reporting factors affecting length of stay. Exclusion criteria were review articles, case study, conferences abstract, and proceedings. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects model was used to analyzed risk factors for length of stay. Heterogeneity was employed using I2 and Q statistics. Forest plots displayed effect sizes (ES) and 95 % confidence intervals. STATA 14.2 was used for meta-analysis. Results: A total of 1,190 studies were screened from reputable electronic databases, six studies comprised of 9,231 participants were included. Meta-analysis revealed that they are six risk factors associated with longer length of stay including; older age (OR 1.50, 95 % CI 1.07–2.09, p = 0.019), comorbidity (OR 1.44, 95 % CI 1.17–1.78, p = 0.001), HIV patient (OR 1.40, 95 % CI 1.16–1.69, p = 0.001), patients with ADR (OR 2.19, 95 % CI 1.47–3.26, p < 0.001), MDR TB (OR 3.16, 95 % CI 2.31–4.32, p < 0.001), and miliary TB (OR 1.37, 95 % CI 1.10–1.70, p = 0.004) with minimal heterogeneity [(I2 = 34.2 %, p = 0.207), (I2 = 43.1 %, p = 0.118), (I2 = 0.0 %, p = 0.573), (I2 = 0.0 %, p = 0.723), (I2 = 0.0 %, p = 0.366), and (I2 = 0.0 %, p = 0.753), respectively]. There was no evidence of publication bias according to Begg's and Egger's test. Conclusions: In conclusion, six risk factors were identified as significantly associated with longer hospital stays in PTB patients: older age, comorbidities, HIV infection, ADR, MDR-TB, and miliary TB. These findings highlight the importance of targeted interventions for these high-risk groups to reduce length of stay and alleviate the burden on healthcare systems. The results are based on a meta-analysis of six studies with minimal heterogeneity, and no evidence of publication bias was found. Future research should focus on exploring additional factors influencing length of stay, particularly in diverse populations, and evaluating the effectiveness of interventions to shorten hospital stays. Additionally, studies examining the impact of healthcare infrastructure and resource allocation on length of stay could provide valuable insights for improving patient outcomes. Registration: This study was registered with PROSPERO, CRD4203390615
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spelling doaj-art-a4f399f0c0dd4d128fef982b765c08af2025-08-20T03:11:14ZengElsevierInternational Journal of Nursing Studies Advances2666-142X2025-06-01810031610.1016/j.ijnsa.2025.100316Risk factors on length of stay among pulmonary tuberculosis patients: A systematic review and meta-analysisDao Weiangkham0Adinat Umnuaypornlert1Surasak Saokaew2Neeranuch Wongcharoen3Samrerng Prommongkol4Jutamas Ponmark5School of Nursing, University of Phayao, Phayao, 56000 ThailandDivision of Social and Administrative Pharmacy (SAP), Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, 56000, Thailand; Unit of Excellence on Clinical Outcomes Research and IntegratioN (UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao, 56000, ThailandDivision of Social and Administrative Pharmacy (SAP), Department of Pharmaceutical Care, School of Pharmaceutical Sciences, University of Phayao, Phayao, 56000, Thailand; Unit of Excellence on Clinical Outcomes Research and IntegratioN (UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao, 56000, Thailand; Center of Excellence in Bioactive Resources for Innovative Clinical Applications, Chulalongkorn University, Bangkok, 10330, Thailand; Corresponding author at: Unit of Excellence on Clinical Outcomes Research and IntegratioN (UNICORN), School of Pharmaceutical Sciences, University of Phayao, Phayao, 56000, Thailand.School of Nursing, University of Phayao, Phayao, 56000 ThailandMahidol Bangkok School of Tropical Medicine (Mahidol-BSTM), Faculty of Tropical Medicine, Mahidol University, Bangkok, 10400 ThailandSchool of Nursing, University of Phayao, Phayao, 56000 Thailand; Corresponding author at: School of Nursing, University of Phayao, 19 Moo 2 T.Maeka, Muang, Phayao, 56000, Thailand.Background: Pulmonary Tuberculosis (PTB) remains a pressing public health concern. Long hospital stays for PTB patients can overburden both patients and healthcare systems. Objective: To identify the key factors contributing to extended length of stay in PTB patients. Information sources: Four electronic databases (PubMed, Scopus, Embase, and CINAHL) were systematically searched from inception to January 1, 2023. Methods: The articles were screened and performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). Inclusion criteria were PTB patients diagnosed by doctors and studies reporting factors affecting length of stay. Exclusion criteria were review articles, case study, conferences abstract, and proceedings. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). A random-effects model was used to analyzed risk factors for length of stay. Heterogeneity was employed using I2 and Q statistics. Forest plots displayed effect sizes (ES) and 95 % confidence intervals. STATA 14.2 was used for meta-analysis. Results: A total of 1,190 studies were screened from reputable electronic databases, six studies comprised of 9,231 participants were included. Meta-analysis revealed that they are six risk factors associated with longer length of stay including; older age (OR 1.50, 95 % CI 1.07–2.09, p = 0.019), comorbidity (OR 1.44, 95 % CI 1.17–1.78, p = 0.001), HIV patient (OR 1.40, 95 % CI 1.16–1.69, p = 0.001), patients with ADR (OR 2.19, 95 % CI 1.47–3.26, p < 0.001), MDR TB (OR 3.16, 95 % CI 2.31–4.32, p < 0.001), and miliary TB (OR 1.37, 95 % CI 1.10–1.70, p = 0.004) with minimal heterogeneity [(I2 = 34.2 %, p = 0.207), (I2 = 43.1 %, p = 0.118), (I2 = 0.0 %, p = 0.573), (I2 = 0.0 %, p = 0.723), (I2 = 0.0 %, p = 0.366), and (I2 = 0.0 %, p = 0.753), respectively]. There was no evidence of publication bias according to Begg's and Egger's test. Conclusions: In conclusion, six risk factors were identified as significantly associated with longer hospital stays in PTB patients: older age, comorbidities, HIV infection, ADR, MDR-TB, and miliary TB. These findings highlight the importance of targeted interventions for these high-risk groups to reduce length of stay and alleviate the burden on healthcare systems. The results are based on a meta-analysis of six studies with minimal heterogeneity, and no evidence of publication bias was found. Future research should focus on exploring additional factors influencing length of stay, particularly in diverse populations, and evaluating the effectiveness of interventions to shorten hospital stays. Additionally, studies examining the impact of healthcare infrastructure and resource allocation on length of stay could provide valuable insights for improving patient outcomes. Registration: This study was registered with PROSPERO, CRD4203390615http://www.sciencedirect.com/science/article/pii/S2666142X25000268Meta-analysisRisk factorsLength of stayPulmonary tuberculosis patients
spellingShingle Dao Weiangkham
Adinat Umnuaypornlert
Surasak Saokaew
Neeranuch Wongcharoen
Samrerng Prommongkol
Jutamas Ponmark
Risk factors on length of stay among pulmonary tuberculosis patients: A systematic review and meta-analysis
International Journal of Nursing Studies Advances
Meta-analysis
Risk factors
Length of stay
Pulmonary tuberculosis patients
title Risk factors on length of stay among pulmonary tuberculosis patients: A systematic review and meta-analysis
title_full Risk factors on length of stay among pulmonary tuberculosis patients: A systematic review and meta-analysis
title_fullStr Risk factors on length of stay among pulmonary tuberculosis patients: A systematic review and meta-analysis
title_full_unstemmed Risk factors on length of stay among pulmonary tuberculosis patients: A systematic review and meta-analysis
title_short Risk factors on length of stay among pulmonary tuberculosis patients: A systematic review and meta-analysis
title_sort risk factors on length of stay among pulmonary tuberculosis patients a systematic review and meta analysis
topic Meta-analysis
Risk factors
Length of stay
Pulmonary tuberculosis patients
url http://www.sciencedirect.com/science/article/pii/S2666142X25000268
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