Risk of pneumococcal diseases in adults with underlying medical conditions: a retrospective, cohort study using two Japanese healthcare databases.
Risk of pneumococcal diseases in adults with underlying medical conditions: a retrospective, cohort study using two Japanese healthcare databases.
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DOI：
10.1136/bmjopen-2017-018553
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发表时间：
2018-03-02
期刊：
影响因子：
2.9
通讯作者：
Kanazu S
中科院分区：
文献类型：
--
作者：
Imai K;Petigara T;Kohn MA;Nakashima K;Aoshima M;Shito A;Kanazu S
在日本，与同龄健康成人相比，量化具有基础医学疾病的≥19岁成人患肺炎球菌性肺炎（PP）和侵袭性肺炎球菌病（IPD）的风险。一项观察性、回顾性、队列研究，使用日本的两个医疗保健索赔数据库：日本医疗数据中心（JMDC）和医疗数据视觉（MDV）数据库。共有1040万人，代表930万人年的随访，被纳入分析。根据疾病和相关健康问题国际统计分类第10版诊断代码和/或日本使用的当地疾病代码，确定了11种医疗状况以及PP和IPD。使用以年龄和/或性别为协变量的多变量泊松回归模型计算有医疗状况的成人与无任何医疗状况的成人的PP和IPD的校正率比（RR）。分别在JMDC和MDV数据库中，年龄≥19岁且患有疾病的成人（PP的RR：3.3至13.4，1.7至5.2; IPD的RR：12.6至43.3，4.4至7.1），患有两种或多种疾病的成人（PP：11.6，2.8; IPD：18.7，5.8）和高危成人（PP：12.9，1.8; IPD：29.7，4.0）与健康对照组相比，PP和IPD的风险更高。有基础疾病的50-64岁成人（PP率：38.6 - 212.1/100 000人-年）的PP率高于无任何疾病的≥65岁成人（PP率：13.2 - 93.0/100 000人-年）。与没有任何医疗条件的成年人相比，所有年龄段有基础医疗条件的成年人患PP和IPD的风险更大。这种风险随着基础医疗条件的增加而增加。我们的研究结果支持将肺炎球菌疫苗接种扩展到有基础疾病的年轻人，特别是50-64岁的人。
To quantify the risk of pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) in adults aged ≥19 years with underlying medical conditions compared with healthy adults of the same age in Japan. An observational, retrospective, cohort study using two healthcare claims databases in Japan: Japan Medical Data Center (JMDC) and Medical Data Vision (MDV) databases. A total of 10.4 million individuals, representing 9.3 million person-years of follow-up, were included in the analysis. Eleven medical conditions as well as PP and IPD were identified by the International Statistical Classification of Diseases and Related Health Problems version 10 diagnostic codes and/or local disease codes used in Japan. Adjusted rate ratios (RRs) for PP and IPD in adults with a medical condition versus adults without any medical condition were calculated using multivariate Poisson regression models with age and/or sex as covariates. In the JMDC and MDV databases, respectively, adults ≥19 years with a medical condition (RRs for PP: 3.3 to 13.4, 1.7 to 5.2; RRs for IPD: 12.6 to 43.3, 4.4 to 7.1), adults with two or more medical conditions (PP: 11.6, 2.8; IPD: 18.7, 5.8) and high-risk adults (PP: 12.9, 1.8; IPD: 29.7, 4.0) were at greater risk of PP and IPD compared with their healthy counterparts. Adults aged 50–64 years with an underlying medical condition (PP rate: 38.6 to 212.1 per 100 000 person-years) had a higher rate of PP than those aged ≥65 years without any condition (PP rate: 13.2 to 93.0 per 100 000 person-years). Adults of all ages with an underlying medical condition are at greater risk of PP and IPD compared with adults without any medical condition. This risk increases with the number of underlying medical conditions. Our results support extending pneumococcal vaccination to younger adults with an underlying medical condition, especially those aged 50–64 years.
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影响因子：
1
作者：
Tanaka S;Seto K;Kawakami K
通讯作者：
Kawakami K
影响因子：
5.5
作者：
Kawakami, Kenji;Ohkusa, Yasushi;Oishi, Kazunori
通讯作者：
Oishi, Kazunori
影响因子：
4.4
作者：
Davis, Keith L.;Meyers, Juliana;Murakami, Masahiro
通讯作者：
Murakami, Masahiro
影响因子：
6.4
作者：
Kyaw, MH;Rose, CE;Whitney, CG
通讯作者：
Whitney, CG
影响因子：
11.8
作者：
Chiba N;Morozumi M;Shouji M;Wajima T;Iwata S;Ubukata K;Invasive Pneumococcal Diseases Surveillance Study Group
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Invasive Pneumococcal Diseases Surveillance Study Group