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肺炎球菌疫苗接种对成年和老年糖尿病患者住院和死亡的有效性:系统评价。

Effectiveness of pneumococcal vaccination on hospitalization and death in the adult and older adult diabetic population: a systematic review.

机构信息

Department of Health Sciences, University of Florence, Firenze, Italy.

Medical School of Specialization in Hygiene and Preventive Medicine, University of Florence, Firenze, Italy.

出版信息

Expert Rev Vaccines. 2023 Jan-Dec;22(1):1179-1184. doi: 10.1080/14760584.2023.2286374. Epub 2023 Nov 27.

Abstract

INTRODUCTION

Diabetic patients are at a higher risk of getting pneumococcal disease and are therefore recommended to get vaccinated. The aim of our systematic review is the retrieval and analysis of all available evidence on the effect of pneumococcal vaccination on the risk of hospitalization and death in adult patients with diabetes.

RESEARCH DESIGN AND METHODS

MEDLINEand EMBASE were searched from inception until January 2023. We included all studies investigating whether pneumococcal vaccination reduces the risk of dying or being hospitalized in diabetic patients. The Newcastle-Ottawa scale was used to assess risk of bias.

RESULTS

Only two studies, encompassing a total of 68,246 subjects, were considered eligible for inclusion and of high quality. In both studies polysaccharide pneumococcal vaccination was associated with a reduction of the risk of hospitalization or death in adult diabetic patients (aHR: 0.76 in one study, aOR: 0.97 in the other one). However, in neither of the two included studies the lower risk was statistically significant.

CONCLUSIONS

Further research is needed due to the potentially major clinical implications for diabetic patients. The results of this systematic review can serve as a foundation for future studies, indicating the importance of continuing research in this area to improve patient outcomes.

摘要

简介

糖尿病患者患肺炎球菌病的风险较高,因此建议接种疫苗。我们的系统评价旨在检索和分析所有关于肺炎球菌疫苗接种对成年糖尿病患者住院和死亡风险影响的现有证据。

研究设计和方法

从创建到 2023 年 1 月,我们在 MEDLINE 和 EMBASE 上进行了搜索。我们纳入了所有研究,这些研究调查了肺炎球菌疫苗接种是否降低了糖尿病患者死亡或住院的风险。纽卡斯尔-渥太华量表用于评估偏倚风险。

结果

仅有两项研究(共纳入 68246 名受试者)被认为符合纳入标准且质量较高。在这两项研究中,多糖肺炎球菌疫苗接种与降低成年糖尿病患者住院或死亡风险相关(一项研究中的 aHR:0.76,另一项研究中的 aOR:0.97)。然而,在这两项纳入的研究中,较低的风险都没有统计学意义。

结论

由于这对糖尿病患者具有潜在的重大临床意义,因此需要进一步研究。本系统评价的结果可以为未来的研究提供基础,表明在该领域继续研究以改善患者结局的重要性。

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