Effectiveness of 23-valent pneumococcal polysaccharide vaccination in preventing community-acquired pneumonia hospitalization and severe outcomes in the elderly in Spain
Por:
Dominguez, A, Soldevila, N, Toledo, D, Torner, N, Force, L, Perez, MJ, Martin, V, Rodriguez-Rojas, L, Astray, J, Egurrola, M, Sanz, F, Castilla, J, Cayla, J.A., Rius, C., Morales Suarez-Varela, Mariá Manuela Del Mar
Publicada:
10 feb 2017
Resumen:
Pneumococcal pneumonia is a serious cause of morbidity and mortality in the elderly, but investigation of the etiological agent of community-acquired pneumonia (CAP) is not possible in most hospitalized patients. The aim of this study was to estimate the effect of pneumococcal polysaccharide vaccination (PPSV23) in preventing CAP hospitalization and reducing the risk of intensive care unit admission (ICU) and fatal outcomes in hospitalized people aged >= 65 years. We made a multicenter case-control study in 20 Spanish hospitals during 2013-2014 and 2014-2015. We selected patients aged >= 65 years hospitalized with a diagnosis of pneumonia and controls matched by sex, age and date of hospitalization. Multivariate analysis was performed using conditional logistic regression to estimate vaccine effectiveness and unconditional logistic regression to evaluate the reduction in the risk of severe and fatal outcomes. 1895 cases and 1895 controls were included; 13.7% of cases and 14.4% of controls had received PPSV23 in the last five years. The effectiveness of PPSV23 in preventing CAP hospitalization was 15.2% (95% CI-3.1-30.3). The benefit of PPSV23 in avoiding ICU admission or death was 28.1% (95% CI-14.3-56.9) in all patients, 30.9% (95% CI-32.2-67.4) in immunocompetent patients and 26.9% (95% CI-38.6-64.8) in immunocompromised patients. In conclusion, PPSV23 showed a modest trend to avoidance of hospitalizations due to CAP and to the prevention of death or ICU admission in elderly patients hospitalized with a diagnosis of CAP.
Filiaciones:
Dominguez, A:
Univ Barcelona, Dept Salut Publ, Barcelona, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Soldevila, N:
Univ Barcelona, Dept Salut Publ, Barcelona, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Toledo, D:
Univ Barcelona, Dept Salut Publ, Barcelona, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Torner, N:
Univ Barcelona, Dept Salut Publ, Barcelona, Spain
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
Agencia Salut Publ Catalunya, Barcelona, Spain
Force, L:
Hosp Mataro, Mataro, Spain
Perez, MJ:
Hosp Univ Virgen de Valme, Seville, Spain
Martin, V:
Univ Leon, Leon, Spain
Rodriguez-Rojas, L:
Hosp Ramon & Cajal, Madrid, Spain
Astray, J:
Consejeria Sanidad, Madrid, Spain
Egurrola, M:
Hosp Galdakao, Usansolo, Spain
Sanz, F:
Univ Valencia, Consorci Hosp Gen, Valencia, Spain
Castilla, J:
CIBER Epidemiol & Salud Publ CIBERESP, Madrid, Spain
IdiSNA, Inst Salud Publ Navarra, Pamplona, Spain
Cayla, J.A.:
Agencia Salut Publ Catalunya, Barcelona, Spain
Rius, C.:
Agencia Salut Publ Catalunya, Barcelona, Spain
Morales Suarez-Varela, Mariá Manuela Del Mar :
Universidad de Valencia, CIBERESP, Spain
Gold, Green Published
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