Beyond Age: Radiological and Inflammatory Factors Associated with Hospital Stay After VATS in Pediatric Complicated Pneumonia—A 10-Year Single-Center Experience

Background/Objectives: We aimed to describe the clinical, laboratory, and radiological characteristics of children with complicated pneumonia/empyema who underwent video-assisted thoracoscopic surgery (VATS) and to identify factors associated with length of hospital stay.

Methods

We retrospectively reviewed 68 children who presented to the pediatric emergency department of a tertiary university hospital and underwent VATS between April 2015 and April 2025. Factors associated with length of stay were assessed using univariable and multivariable negative binomial regression.

Results

Median age was 60 months (interquartile range 36–138), and 66% were male. On univariable analysis, C-reactive protein (CRP) was associated with length of stay (incidence rate ratio [IRR] = 1.03 per 100 mg/L; p = 0.034), whereas age was not (p = 0.542). In the multivariable model, CRP remained borderline associated (IRR = 1.03; 95% confidence interval [CI] 1.00–1.06; p = 0.049), whereas performance of computed tomography was not (p = 0.142). An atypical (gastrointestinal or pain-predominant) presentation occurred in 25%. Streptococcus pneumoniae was the most frequently detected bacterial pathogen, mainly by nasopharyngeal polymerase chain reaction.