Interrupted time-series analyses of routine vaccination program for elderly pneumonia patients in Japan; an ecological study using aggregated nationwide inpatient data
Interrupted time-series analyses of routine vaccination program for elderly pneumonia patients in Japan; an ecological study using aggregated nationwide inpatient data
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日本老年肺炎患者常规疫苗接种计划的间断时间序列分析；
DOI：
10.1080/21645515.2021.1875760
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Nagai Hideaki
中科院分区：
文献类型：
--
作者：
Kobayashi Koichi;Jo Taisuke;Mimura Wataru;Suzukawa Maho;Ohshima Nobuharu;Tanaka Goh;Akazawa Manabu;Matsui Hiroki;Fushimi Kiyohide;Yasunaga Hideo;Nagase Takahide;Nagai Hideaki
日本于2014年开始实施全国性的肺炎球菌肺炎常规免疫接种计划。它针对年龄≥65岁的人群，使用23价肺炎球菌多糖疫苗; PPSV 23。然而，由于缺乏关于每例受试者PPSV 23疫苗接种状态的综合数据库，因此其有效性尚未明确。我们采用中断时间序列分析来评估老年肺炎住院患者在项目启动前后的发病率和预后的变化。首先，我们根据PPSV 23注射器的运输数量和每个都道府县的估计人口，估计了≥65岁受试者中的PPSV 23覆盖率。2014年，东北3县的估计覆盖率达到40%左右，其他都道府县的估计覆盖率仍低于20%。国家常规免疫规划启动后，各都道府县的估计接种率大幅提高，2017年超过40%。接下来，我们汇总了2011年4月至2017年2月从日本诊断程序组合数据库中提取的年龄≥65岁的住院肺炎患者的数据。数据包括655，746名患者的数据，不包括东北3个县的患者。中断时间序列分析发现，接种疫苗后住院肺炎患者的发病率和住院死亡率没有变化，但有严重合并症的肺炎患者的住院死亡率下降，定义为改良的Charlson合并症指数。这些结果表明，在日本，疫苗接种计划与伴有严重合并症的住院老年肺炎患者结局改善之间存在关联。
A national routine pneumococcal pneumonia immunization program started in Japan in 2014. It targeted the population aged ≥65 years and used a 23-valent pneumococcal polysaccharide vaccine; PPSV23. However, its effectiveness was not well defined because of the lack of a comprehensive database on the PPSV23 vaccination status of each subject. We used interrupted time-series analyses to assess the changes in the incidence and prognosis of elderly patients hospitalized for pneumonia before and after initiation of the program. First, we estimated the PPSV23 coverage rates in subjects aged ≥65 years based on the number of shipped PPSV23 syringes and the estimated population in each prefecture. The estimated coverage rates reached around 40% in 2014 for the 3 Tohoku prefectures, while those in the other prefectures remained below 20%. After the national routine immunization program started, the estimated coverage rate increased significantly in every prefecture and exceeded 40% in 2017. Next, we aggregated the data extracted from the Japanese Diagnosis Procedure Combination database from April 2011 through February 2017 for hospitalized pneumonia patients aged ≥65 years. The data included data from 655,746 patients, excluding those in the 3 Tohoku prefectures. Interrupted time-series analyses found no change in the incidence of hospitalized pneumonia patients and in-hospital mortality after the vaccination program, but there was a decrease in the in-hospital mortality of pneumonia patients with severe comorbidities defined by the modified Charlson comorbidity index. These results suggest an association between the vaccination program and an improved outcome in hospitalized elderly pneumonia patients with severe comorbidities in Japan.
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影响因子：
11.7
作者：
Akyil, F. Tokgoz;Yalcinsoy, M.;Edis, E. Cakir
通讯作者：
Edis, E. Cakir
1988-2002 年美国 65 岁及以上人群肺炎住院趋势 Fry AM、Shay DK、Holman RC 等人（佐治亚州亚特兰大疾病控制与预防中心）JAMA 294：2712-2719，2005 §
DOI：
--
发表时间：
2007
期刊：
影响因子：
--
作者：
J. Maurer
通讯作者：
J. Maurer
影响因子：
120.7
作者：
Fry, AM;Shay, DK;Anderson, LJ
通讯作者：
Anderson, LJ
影响因子：
11.8
作者：
Ubukata K;Takata M;Morozumi M;Chiba N;Wajima T;Hanada S;Shouji M;Sakuma M;Iwata S;Invasive Pneumococcal Diseases Surveillance Study Group
通讯作者：
Invasive Pneumococcal Diseases Surveillance Study Group
影响因子：
6.4
作者：
Simonsen L;Taylor RJ;Young-Xu Y;Haber M;May L;Klugman KP
通讯作者：
Klugman KP