Hospital-based pneumococcal immunization. Epidemiologic rationale from the Shenandoah study
D. S. Fedson, M. P. Harward, R. A. Reid and D. L. Kaiser
Department of Medicine, University of Virginia School of Medicine, Charlottesville.
To explore the potential usefulness of a strategy of hospital-based
pneumococcal immunization, we studied a population-based linked record of
hospital discharges for Medicare enrollees living in the Shenandoah region
of Virginia. A retrospective study of 1633 persons discharged with
pneumonia in 1983 showed that 61% to 62% had been discharged within the
previous 4 years. Among these patients, 87% had had one or more high-risk
conditions recognized during previous hospital admissions. A cohort study
demonstrated that discharged patients had a 6% to 9% probability of
readmission with pneumonia within 5 years. Each such readmission could be
prevented by immunizing few (approximately 100) discharged patients with
pneumococcal vaccine. Furthermore, the costs of vaccination would be
approximately one-third the costs of hospital care for unvaccinated
discharged patients readmitted with pneumonia. These results provide an
epidemiologic rationale for current recommendations that elderly patients
discharged from hospitals should be immunized with pneumococcal vaccine.
A case for immunization against nosocomial infections
Cross et al.
J. Leukoc. Biol. 2008;83:483-488.
ABSTRACT
| FULL TEXT
Influenza and Pneumococcal Immunization in Diabetes
Diabetes Care 2004;27:s111-113.
FULL TEXT
Immunization and the Prevention of Influenza and Pneumococcal Disease in People With Diabetes
Diabetes Care 2003;26:s126-128.
FULL TEXT
Failure to Vaccinate Medicare Inpatients: A Missed Opportunity
Bratzler et al.
Arch Intern Med 2002;162:2349-2356.
ABSTRACT
| FULL TEXT
Quality Indicators for the Management of Pneumonia in Vulnerable Elders
Rhew
ANN INTERN MED 2001;135:736-743.
FULL TEXT
A Computerized Reminder System to Increase the Use of Preventive Care for Hospitalized Patients
Dexter et al.
NEJM 2001;345:965-970.
ABSTRACT
| FULL TEXT
Guidelines for the Management of Adults with Community-acquired Pneumonia . Diagnosis, Assessment of Severity, Antimicrobial Therapy, and Prevention
Niederman et al.
Am. J. Respir. Crit. Care Med. 2001;163:1730-1754.
FULL TEXT
Smoking and Pneumococcal Infection
Sheffield and Root
NEJM 2000;342:732-734.
FULL TEXT
Prognosis After Community-Acquired Pneumonia in the Elderly: A Population-Based 12-Year Follow-up Study
Koivula et al.
Arch Intern Med 1999;159:1550-1555.
ABSTRACT
| FULL TEXT
A Hospital-Based Pharmacy Intervention Program for Pneumococcal Vaccination
Vondracek et al.
Arch Intern Med 1998;158:1543-1547.
ABSTRACT
| FULL TEXT
Immunization of Adults
Gardner and Schaffner
NEJM 1993;328:1252-1258.
FULL TEXT