Department of Infectious Diseases, Bellvitge Biomedical Research Institute-Hospital Universitari de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
J Am Geriatr Soc. 2011 Sep;59(9):1711-6. doi: 10.1111/j.1532-5415.2011.03541.x. Epub 2011 Aug 1.
To determine whether prior pneumococcal and seasonal influenza vaccination improves outcomes in older adults hospitalized for community-acquired pneumonia (CAP).
Prospective, observational, multicenter study.
Five public hospitals providing universal free care to the whole population in three Spanish regions.
Individuals aged 65 and older admitted to the hospital with CAP through the emergency department.
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.
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.
The clinical outcomes of vaccinated older adults hospitalized with CAP were not better than those observed in unvaccinated individuals.
确定老年人因社区获得性肺炎（CAP）住院前接种肺炎球菌和季节性流感疫苗是否能改善结局。
前瞻性、观察性、多中心研究。
西班牙三个地区的五家公立医院，为全体居民提供免费的全民医疗保健。
因 CAP 通过急诊部住院的年龄在 65 岁及以上的个体。
肺炎球菌和流感疫苗接种状况。主要研究结局为入住重症监护病房（ICU）、住院时间（LOS）和总体病死率。比较了同时接种两种疫苗的个体与未接种疫苗的个体的结局。
238 名个体接种了 23 价肺炎球菌多糖疫苗和季节性流感疫苗，并与 195 名未接种疫苗的个体进行了比较。两组之间联合抗生素治疗的差异无统计学意义（38.0%对 39.7%；P =.80）。需要入住 ICU 的接种者和未接种者的比例相似（7.2%对 8.2%；P =.69）。接种者的 LOS 明显缩短（9.9 天对 12.4 天；P =.04）。两组的总体病死率相似（5.9%对 5.1%；P =.73）。调整后，LOS、入住 ICU 的风险和总体病死率与肺炎球菌和季节性流感疫苗接种无关。
因 CAP 住院的接种老年人的临床结局并不优于未接种者。
