Influence of Prior Pneumococcal and Influenza Vaccination on Outcomes of Older Adults with Community-Acquired Pneumonia
Por:
Manzur, A, Izquierdo, C, Ruiz, L, Sousa, D, Bayas, JM, Celorrio, JM, Varona, W, Nebot, M, Salleras, L, Dominguez, A, Carratala, J
Publicada:
1 sep 2011
Resumen:
OBJECTIVES: To determine whether prior pneumococcal and seasonal influenza vaccination improves outcomes in older adults hospitalized for community-acquired pneumonia (CAP).
DESIGN: Prospective, observational, multicenter study.
SETTING: Five public hospitals providing universal free care to the whole population in three Spanish regions.
PARTICIPANTS: Individuals aged 65 and older admitted to the hospital with CAP through the emergency department.
MEASUREMENTS: Pneumococcal and influenza vaccination status. The primary study outcomes were intensive care unit (ICU) admission, length of hospital stay (LOS), and overall case-fatality rate. Outcome variables of individuals vaccinated with both vaccines were compared with outcomes of those who were unvaccinated.
RESULTS: Two hundred thirty-eight individuals had received 23-valent pneumococcal polysaccharide vaccine and seasonal influenza vaccination and were compared with 195 unvaccinated individuals. No differences were found with respect to combined antibiotic therapy between groups (38.0% vs 39.7%; P=.80). Similar percentages of vaccinated and unvaccinated individuals required ICU admission (7.2% vs 8.2%; P=.69). Mean LOS was significantly shorter in vaccinated individuals (9.9 vs 12.4 days; P=.04). Overall case-fatality rates were similar in both groups (5.9% vs 5.1%; P=.73). After adjustment, LOS, risk of ICU admission, and overall case-fatality rate were not associated with prior pneumococcal and seasonal influenza vaccination.
CONCLUSION: The clinical outcomes of vaccinated older adults hospitalized with CAP were not better than those observed in unvaccinated individuals. J Am Geriatr Soc 59: 1711-1716, 2011.
Filiaciones:
Manzur, A:
Univ Barcelona, Hosp Univ Bellvitge, Bellvitge Biomed Res Inst, Dept Infect Dis, Barcelona, Spain
Izquierdo, C:
Generalitat Catalonia, Dept Hlth, Barcelona 08005, Spain
Ruiz, L:
Generalitat Catalonia, Dept Hlth, Barcelona 08005, Spain
Sousa, D:
Hosp Juan Canalejo, Dept Infect Dis, La Coruna, Spain
Bayas, JM:
Hosp Clin Barcelona, Dept Prevent Med & Epidemiol, Barcelona, Spain
Celorrio, JM:
Hosp Ernest Lluch, Dept Prevent Med, Calatayud, Spain
Varona, W:
Hosp Royo Villanova, Dept Prevent Med, Zaragoza, Spain
Nebot, M:
Publ Hlth Agcy Barcelona, Dept Assessment & Intervent Methods, Barcelona, Spain
Ctr Invest Biomed Red CIBER Epidemiol & Salud Pub, Madrid, Spain
Salleras, L:
Ctr Invest Biomed Red CIBER Epidemiol & Salud Pub, Madrid, Spain
Univ Barcelona, Dept Publ Hlth, Barcelona, Spain
Dominguez, A:
Ctr Invest Biomed Red CIBER Epidemiol & Salud Pub, Madrid, Spain
Univ Barcelona, Dept Publ Hlth, Barcelona, Spain
Carratala, J:
Univ Barcelona, Hosp Univ Bellvitge, Bellvitge Biomed Res Inst, Dept Infect Dis, Barcelona, Spain
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