Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
Department of Respiratory Medicine, Fujisawa City Municipal Hospital, Fujisawa, Japan.
Can Respir J. 2021 Nov 16;2021:5644824. doi: 10.1155/2021/5644824. eCollection 2021.
Pneumonia is a common disease among the aging population in Japan. Hence, it is important to elucidate the risks related to pneumonia mortality. Since is the most commonly observed pathogen, pneumococcal vaccination is recommended to older adults. Therefore, this study aimed to clarify the clinical features of pneumonia, including the status of pneumococcal vaccination, in hospitalized older adult patients in Japan.
This single-centered retrospective study was conducted by reviewing the medical records of all patients with acute pneumonia at Fujisawa City Hospital in Japan from April 2018 to March 2019. Patients were divided into two groups based on their history of pneumococcal vaccination. The primary endpoint was in-hospital mortality, while the secondary endpoint was risk factors associated with mortality.
We included 93 patients with pneumonia in this retrospective study. Although the mortality rate was higher in the vaccinated group (15.8%) than in the unvaccinated group (9.1%), vaccination status was not identified as a significant risk factor for mortality after multivariable logistic regression (odds ratio: 2.71; 95% confidence interval: 0.667-11.02; =0.16). In addition, the A-DROP score was identified as an independent risk factor (odds ratio: 2.64; 95% confidence interval: 1.22-5.72; =0.008).
Our study suggested that the A-DROP score is a risk factor of mortality for pneumonia in older adults. In addition, pneumococcal vaccination history was related to increased mortality; however, the influence of the vaccination remains unclear because of the small sample size.
肺炎是日本老年人群中的一种常见疾病。因此，阐明与肺炎死亡率相关的风险因素非常重要。由于肺炎球菌是最常见的病原体，建议给老年人接种肺炎球菌疫苗。因此，本研究旨在阐明日本住院老年患者肺炎的临床特征，包括肺炎球菌疫苗接种情况。
这是一项单中心回顾性研究，通过回顾日本藤泽市医院 2018 年 4 月至 2019 年 3 月期间所有急性肺炎患者的病历进行。根据肺炎球菌疫苗接种史将患者分为两组。主要终点为住院期间死亡率，次要终点为与死亡率相关的危险因素。
本回顾性研究共纳入 93 例肺炎患者。虽然接种组的死亡率（15.8%）高于未接种组（9.1%），但多变量逻辑回归分析未发现接种状态是死亡的显著危险因素（比值比：2.71；95%置信区间：0.667-11.02；=0.16）。此外，A-DROP 评分被确定为独立的危险因素（比值比：2.64；95%置信区间：1.22-5.72；=0.008）。
本研究表明，A-DROP 评分是老年人肺炎死亡的危险因素。此外，肺炎球菌疫苗接种史与死亡率增加有关；然而，由于样本量小，疫苗接种的影响仍不清楚。
