[Risk of pneumococcal disease in elderly patients with and without previous vaccination].

Autor:	Flores-Copete M; Servicio de Urgencias, Complejo Hospitalario Universitario de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, España., Reolid-Martínez R; Servicio de Urgencias, Complejo Hospitalario Universitario de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, España., López-García M; Centro de Salud de Casas Ibáñez, Servicio de Salud de Castilla-La Mancha (SESCAM), Casas Ibáñez, Albacete, España., Alcantud-Lozano P; Centro de Salud Zona IV de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, España., Mudarra-Tercero E; Centro de Salud Zona IV de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, España., Azorín-Ras M; Centro de Salud Zona IV de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, España., Del Campo-Giménez M; Centro de Salud Zona IV de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, España., Ayuso-Raya MC; Servicio de Urgencias, Complejo Hospitalario Universitario de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, España., Escobar-Rabadán F; Centro de Salud Zona IV de Albacete, Servicio de Salud de Castilla-La Mancha (SESCAM), Albacete, España. Electronic address: fjescobarr@sescam.jccm.es.
Jazyk:	Spanish; Castilian
Zdroj:	Atencion primaria [Aten Primaria] 2019 Nov; Vol. 51 (9), pp. 571-578. Date of Electronic Publication: 2018 Nov 01.
DOI:	10.1016/j.aprim.2018.07.009
Abstrakt:	Objectives: To know the pneumococcal vaccination coverage in patients≥65 years old, as well as the risk of pneumococcal disease according to whether or not they received such vaccination. Design: Cross-sectional study, followed by historical cohort. Location: Urban area. Participants: By systematic sampling, 2,805 people≥65 years from the city of Albacete were selected. Main Measurements: Dependent variable: diagnosis of pneumococcal disease and date. Independent Variables: age, sex, chronic pathologies, medication, pneumococcal vaccination and date. The computerized medical records were reviewed, from 1-1-2009 to October-December 2015. A descriptive analysis was carried out, the relative risk of the onset of pneumococcal disease according to vaccination has been calculated, and survival analysis has been carried out, with the statistical program SPSS 17.0. Results: Median age 71 years; 57.2% were women; 46% received polysaccharide vaccine (95% CI 44.1-47.8). Only 10 people received conjugated vaccine. Twenty-two people were diagnosed with invasive pneumococcal disease and 153 non-invasive. The relative risk of pneumococcal disease in vaccinated versus unvaccinated, respectively for invasive and non-invasive, was 1.59 (95% CI 0.69-3.68) and 1.84 (95% CI 1.33-2.54). Cox regression showed a higher risk of non-invasive disease for COPD (1.95; 95% CI 1.32-2.89), smoking (1.87; 95% CI 1.28-2.73), corticoid-therapy (1.73; 95% CI 1.08-2.79), polysaccharide vaccination (141.41; 95% CI 5.92-3,378.49) and age (1.11; 95% CI 1.08-1.14), with interaction between these 2 (0.94, 95% CI 0.91-0.98). Conclusions: There is an increased risk of pneumococcal disease in patients≥65 years vaccinated with polysaccharide, although with a protective effect in vaccinated older. (Copyright © 2018 The Authors. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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