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三价季节性流感疫苗接种对降低中国养老院老年人死亡率和住院率的效果。

Efficacy of trivalent seasonal influenza vaccination in reducing mortality and hospitalization in Chinese nursing home older adults.

机构信息

Department of Medicine and Geriatrics, The University of Hong Kong, Fung Yiu King Hospital, Hong Kong SAR, China; Division of Geriatrics, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong SAR, China.

出版信息

J Am Med Dir Assoc. 2013 Dec;14(12):889-94. doi: 10.1016/j.jamda.2013.04.004. Epub 2013 May 21.

Abstract

OBJECTIVE

To examine the clinical efficacy of the trivalent seasonal influenza vaccination among Chinese older adults residing in a nursing home.

DESIGN

A 12-month prospective cohort study. Participants were divided into 2 groups based on their own choice on vaccination of trivalent seasonal influenza vaccine: vaccinated group and unvaccinated group.

SETTING

Fifty-eight nursing homes in Hong Kong.

PARTICIPANTS

A total of 1859 older adults residing in a nursing home.

MEASUREMENTS

All-cause mortality, pneumonia-related mortality, all-cause hospitalization, and pneumonia-related hospitalization.

RESULTS

A total of 1859 older adults residing in a nursing home were included: 1214 (65.3%) in the vaccinated group and 645 (34.7%) in the unvaccinated group. At 12 months of study, for all-cause mortality, 14.6% (177 of 1214) of the vaccinated group and 20.2% (130 of 645) of the unvaccinated group had died (P < .001). Multivariate analysis showed the hazard ratio for the vaccinated group was 0.72 (95% confidence interval [CI]: 0.54-0.95; P < .01). For pneumonia-related mortality, 9.4% (114 of 1214) of the vaccinated group and 12.7% (82 of 645) of the unvaccinated group died (P = .033). Multivariate analysis showed the hazard ratio for the vaccinated group was 0.80 (CI: 0.62-0.98; P < .05). The median number of all-cause hospitalizations per 1000 person-months was 55 (0-111) for the vaccinated group and 55 (0-167) for the unvaccinated group (P < .01). The median number of pneumonia-related hospitalizations per 1000 person-months was 0 (0-55) for the vaccinated group and 0 (0-111) for the unvaccinated group (P < .01).

CONCLUSIONS

Vaccination of trivalent seasonal influenza vaccine in Chinese nursing home older adults significantly reduced all-cause and pneumonia-related mortality and hospitalization.

摘要

目的

考察接种三价季节性流感疫苗对居住在养老院的中国老年人的临床疗效。

设计

一项为期 12 个月的前瞻性队列研究。参与者根据自己对三价季节性流感疫苗接种的选择分为两组:接种组和未接种组。

地点

香港 58 家养老院。

参与者

共有 1859 名居住在养老院的老年人。

测量

全因死亡率、肺炎相关死亡率、全因住院率和肺炎相关住院率。

结果

共纳入 1859 名居住在养老院的老年人:接种组 1214 人(65.3%),未接种组 645 人(34.7%)。在 12 个月的研究中,全因死亡率方面,接种组有 14.6%(177/1214)的人死亡,未接种组有 20.2%(130/645)的人死亡(P<0.001)。多变量分析显示,接种组的风险比为 0.72(95%置信区间:0.54-0.95;P<0.01)。肺炎相关死亡率方面,接种组有 9.4%(114/1214)的人死亡,未接种组有 12.7%(82/645)的人死亡(P=0.033)。多变量分析显示,接种组的风险比为 0.80(95%置信区间:0.62-0.98;P<0.05)。每 1000 人月的全因住院人数中位数,接种组为 55(0-111),未接种组为 55(0-167)(P<0.01)。每 1000 人月的肺炎相关住院人数中位数,接种组为 0(0-55),未接种组为 0(0-111)(P<0.01)。

结论

在中国养老院老年人中接种三价季节性流感疫苗可显著降低全因死亡率、肺炎相关死亡率和住院率。

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