Pneumococcal vaccination reduces in-hospital mortality, length of stay and medical expenditure in hospitalized elderly patients.
Aged
Aged, 80 and over
Female
Health Expenditures
/ statistics & numerical data
Hospital Mortality
Humans
Immunization Programs
Japan
/ epidemiology
Length of Stay
/ economics
Male
Patient Admission
/ economics
Pneumococcal Infections
/ economics
Pneumococcal Vaccines
/ administration & dosage
Retrospective Studies
Treatment Outcome
Elderly patients
In-hospital mortality
Length of hospital stays
Medical expenditure
Pneumococcal vaccination
Journal
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
ISSN: 1437-7780
Titre abrégé: J Infect Chemother
Pays: Netherlands
ID NLM: 9608375
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
15
08
2019
revised:
04
03
2020
accepted:
25
03
2020
pubmed:
27
4
2020
medline:
7
4
2021
entrez:
27
4
2020
Statut:
ppublish
Résumé
Pneumococcal vaccination has been shown to reduce occurrence of invasive pneumococcal diseases in elderly patients. In this study, we investigated the real-world efficacy of pneumococcal vaccination implemented in elderly individuals in Japan. We reviewed the in-patient database of Juntendo University Hospital and selected elderly patients (≥65 years-old) who had received in-patient care in the general medicine department during 2014-2018. A total of 1355 patients were retrospectively enrolled and comprised of 1045 unvaccinated and 315 vaccinated elderly individuals. Prior vaccination was found associated with all-cause shorter hospital stays (adjusted RR = 0.66, 95% CI = 0.57 to 0.76) and less medical expenditure (adjusted RR = 0.76, 95% CI = 0.66 to 0.87) compared with no vaccination, as well as protection for all-cause in-hospital mortality (adjusted OR = 0.42, 95% CI = 0.22 to 0.83). The association of shorter hospital stays and less medical expenditure with vaccination was also observed in the context of pneumonia, although no altered risk in mortality was observed. In conclusion, this study is one of the first reporting real-world data after the initiation of pneumococcal vaccination program in 2014 in Japan. The national PPV23 vaccination program contributed to the reduction of all-cause in-patient days, mortality, and medical expenses in the elderly aged ≥65 years. Further data is warranted to evaluate the contribution from influenza vaccination and protein-conjugate based pneumococcal vaccine.
Identifiants
pubmed: 32334952
pii: S1341-321X(20)30110-0
doi: 10.1016/j.jiac.2020.03.016
pii:
doi:
Substances chimiques
23-valent pneumococcal capsular polysaccharide vaccine
0
Pneumococcal Vaccines
0
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
715-721Informations de copyright
Copyright © 2020 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest T.N. has received honoraria for lectures from MSD K.K. A.W. has received honoraria for lectures from MSD K.K and Pfizer K.K. The authors declare that they have no known competing financial interests.