Department of Health Services Management & Policy, Kyushu University Graduate School of Medicine, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan.
Environ Health Prev Med. 2002 Nov;7(5):183-8. doi: 10.1007/BF02898002.
Although many studies have shown the usefulness of influenza vaccine in elderly in-patients, the efficacy of vaccination with regard to the daily physical activities of patients has not been fully evaluated. To address this issue, we correlated the use of medical resources with vaccination status in patients categorized according to their daily activity levels.
The subjects comprised 237 in-patients at or above 51 years of age, who were hospitalized in the long-term care unit of a Japanese hospital between January and March, 1999. The vaccination status and medical resources use (i.e., oral antibiotics, injected antibiotics, blood cell count, chest X-ray) of each patient were recorded, and the patients were assigned to three subgroups, based on daily life activity scores.
Vaccinated in-patients in the 'bed-bound' category required fewer medical resources, i.e., oral antibiotics (-2.29 days,P<0.05), injected antibiotics (-5.02 days,P<0.001), blood cell counts (-4.66 times,P<0.001), and chest X-rays (-4.31 times,P<0.001), compared with unvaccinated in-patients. There were no significant differences in treatment parameters between vaccinated and unvaccinated patients in the 'partly limited' or 'no limitation' categories.
It is suggested that influenza vaccination significantly reduces the need for medical treatment only among those in-patients who are the least physically active. Further studies are required to replicate these findings, and to elucidate the underlying reasons for this reduction.
虽然许多研究表明流感疫苗对老年住院患者有用,但疫苗接种对患者日常活动能力的效果尚未得到充分评估。为了解决这个问题,我们根据患者的日常活动水平将其分为几类,并将医疗资源的使用与疫苗接种状况相关联。
研究对象为 1999 年 1 月至 3 月期间在日本一家医院长期护理病房住院的 237 名年龄在 51 岁及以上的患者。记录每位患者的疫苗接种状况和医疗资源使用情况(即口服抗生素、注射用抗生素、血细胞计数、胸部 X 线),并根据日常生活活动评分将患者分为三组。
“卧床不起”类别的接种患者所需的医疗资源较少,即口服抗生素(-2.29 天,P<0.05)、注射用抗生素(-5.02 天,P<0.001)、血细胞计数(-4.66 倍,P<0.001)和胸部 X 射线(-4.31 次,P<0.001),与未接种患者相比。在“部分受限”或“无限制”类别中,接种和未接种患者的治疗参数没有显著差异。
流感疫苗接种可显著减少仅在活动能力最低的住院患者中治疗的需求。需要进一步的研究来复制这些发现,并阐明这种减少的原因。