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Prior pneumococcal vaccination is associated with reduced death, complications, and length of stay among hospitalized adults with community-acquired pneumonia.
Clin Infect Dis. 2006 Apr 15; 42(8):1093-101.CI

Abstract

BACKGROUND

Vaccination with pneumococcal polysaccharide reduces the incidence of bacteremic pneumococcal disease in adults. We investigated the impact of prior pneumococcal vaccination on in-hospital mortality and the probability of respiratory failure among hospitalized adults with community-acquired pneumonia.

METHODS

Consecutive individuals hospitalized with community-acquired pneumonia (diagnosed by International Classification of Diseases, Ninth Revision, Clinical Modification codes 480.0-487.0) at 109 community and teaching hospitals in the United States were identified using the Quality and Resource Management System, a database constructed by Tenet HealthCare to improve the quality of patient care. Vaccination status, comorbidities, and outcomes were abstracted by case managers concurrently with patient care. Associations between vaccination, survival, and respiratory failure were defined using multivariable logistic regression models.

RESULTS

Of 62,918 adults hospitalized with community-acquired pneumonia between 1999 and 2003, 7390 (12%) had a record of prior pneumococcal vaccination. Vaccine recipients were less likely to die of any cause during hospitalization than were individuals with no record of vaccination (adjusted odds ratio [OR], 0.50; 95% confidence interval [CI], 0.43-0.59), even after adjustment for the presence of comorbid illnesses, age, smoking, and influenza vaccination and under varying assumptions about missing vaccination data. Vaccination also lowered the risk of respiratory failure (adjusted OR, 0.67; 95% CI, 0.59-0.76) and other complications and reduced median length of stay by 2 days, compared with nonvaccination (P<.001).

CONCLUSIONS

Prior vaccination against pneumococcus is associated with improved survival, decreased chance of respiratory failure or other complications, and decreased length of stay among hospitalized patients with community-acquired pneumonia. These observations reinforce current efforts to improve compliance with existing pneumococcal vaccination recommendations for adults.

Authors+Show Affiliations

School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA. dfisman@princeton.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16575726

Citation

Fisman, David N., et al. "Prior Pneumococcal Vaccination Is Associated With Reduced Death, Complications, and Length of Stay Among Hospitalized Adults With Community-acquired Pneumonia." Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, vol. 42, no. 8, 2006, pp. 1093-101.
Fisman DN, Abrutyn E, Spaude KA, et al. Prior pneumococcal vaccination is associated with reduced death, complications, and length of stay among hospitalized adults with community-acquired pneumonia. Clin Infect Dis. 2006;42(8):1093-101.
Fisman, D. N., Abrutyn, E., Spaude, K. A., Kim, A., Kirchner, C., & Daley, J. (2006). Prior pneumococcal vaccination is associated with reduced death, complications, and length of stay among hospitalized adults with community-acquired pneumonia. Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America, 42(8), 1093-101.
Fisman DN, et al. Prior Pneumococcal Vaccination Is Associated With Reduced Death, Complications, and Length of Stay Among Hospitalized Adults With Community-acquired Pneumonia. Clin Infect Dis. 2006 Apr 15;42(8):1093-101. PubMed PMID: 16575726.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prior pneumococcal vaccination is associated with reduced death, complications, and length of stay among hospitalized adults with community-acquired pneumonia. AU - Fisman,David N, AU - Abrutyn,Elias, AU - Spaude,Kimberly A, AU - Kim,Alex, AU - Kirchner,Cheryl, AU - Daley,Jennifer, Y1 - 2006/03/13/ PY - 2005/08/24/received PY - 2005/12/19/accepted PY - 2006/4/1/pubmed PY - 2006/8/2/medline PY - 2006/4/1/entrez SP - 1093 EP - 101 JF - Clinical infectious diseases : an official publication of the Infectious Diseases Society of America JO - Clin Infect Dis VL - 42 IS - 8 N2 - BACKGROUND: Vaccination with pneumococcal polysaccharide reduces the incidence of bacteremic pneumococcal disease in adults. We investigated the impact of prior pneumococcal vaccination on in-hospital mortality and the probability of respiratory failure among hospitalized adults with community-acquired pneumonia. METHODS: Consecutive individuals hospitalized with community-acquired pneumonia (diagnosed by International Classification of Diseases, Ninth Revision, Clinical Modification codes 480.0-487.0) at 109 community and teaching hospitals in the United States were identified using the Quality and Resource Management System, a database constructed by Tenet HealthCare to improve the quality of patient care. Vaccination status, comorbidities, and outcomes were abstracted by case managers concurrently with patient care. Associations between vaccination, survival, and respiratory failure were defined using multivariable logistic regression models. RESULTS: Of 62,918 adults hospitalized with community-acquired pneumonia between 1999 and 2003, 7390 (12%) had a record of prior pneumococcal vaccination. Vaccine recipients were less likely to die of any cause during hospitalization than were individuals with no record of vaccination (adjusted odds ratio [OR], 0.50; 95% confidence interval [CI], 0.43-0.59), even after adjustment for the presence of comorbid illnesses, age, smoking, and influenza vaccination and under varying assumptions about missing vaccination data. Vaccination also lowered the risk of respiratory failure (adjusted OR, 0.67; 95% CI, 0.59-0.76) and other complications and reduced median length of stay by 2 days, compared with nonvaccination (P<.001). CONCLUSIONS: Prior vaccination against pneumococcus is associated with improved survival, decreased chance of respiratory failure or other complications, and decreased length of stay among hospitalized patients with community-acquired pneumonia. These observations reinforce current efforts to improve compliance with existing pneumococcal vaccination recommendations for adults. SN - 1537-6591 UR - https://www.unboundmedicine.com/medline/citation/16575726/Prior_pneumococcal_vaccination_is_associated_with_reduced_death_complications_and_length_of_stay_among_hospitalized_adults_with_community_acquired_pneumonia_ L2 - https://academic.oup.com/cid/article-lookup/doi/10.1086/501354 DB - PRIME DP - Unbound Medicine ER -