Effect of Influenza Vaccination of Nursing Home Staff on Mortality of Residents: A Cluster-Randomized Trial
Effect of Influenza Vaccination of Nursing Home Staff on Mortality of Residents: A Cluster-Randomized Trial
复制标题
DOI：
10.1111/j.1532-5415.2009.02402.x
复制
发表时间：
2009-09-01
影响因子：
6.3
通讯作者：
Carrat, Fabrice
中科院分区：
文献类型：
--
作者：
Lemaitre, Magali;Meret, Thierry;Carrat, Fabrice
目的：评估工作人员流感疫苗接种对疗养院居民全因死亡率的影响。设计：配对整群随机试验。地点：40 个疗养院的规模、上一季节的工作人员疫苗接种覆盖率和居民残疾指数相匹配。参与者：所有居住在疗养院的 60 岁及以上老人。干预：接种流感疫苗 志愿者工作人员经过面对面采访后。对照疗养院不进行干预。 测量：主要终点是社区流感流行前两周至流行后两周居民的总死亡率。次要终点是居民的住院率和流感样疾病 (ILI) 率以及工作人员的病假率。结果：疫苗接种组的工作人员流感疫苗接种率为 69.9%，而对照组为 31.8%。初步未经调整的分析并未显示疫苗接种组居民的死亡率显着降低（比值比 = 0.86，P = .08），尽管多变量调整分析显示死亡率降低了 20%（P = .02），并且在工作人员疫苗接种覆盖率与居民全因死亡率之间观察到很强的相关性（相关系数 = -0.42，P = .007）。在疫苗接种组中，没有观察到居民住院率显着降低，但居民的 ILI 降低了 31% (P = .007)，工作人员的病假降低了 42% (P = .03)。 结论：这些结果支持护理机构老年人的工作人员接种流感疫苗。 J Am Geriatr Soc 57：1580-1586，2009。
OBJECTIVES: To evaluate the effect of staff influenza vaccination on all-cause mortality in nursing home residents.DESIGN: Pair-matched cluster-randomized trial.SETTING: Forty nursing homes matched for size, staff vaccination coverage during the previous season, and resident disability index.PARTICIPANTS: All persons aged 60 and older residing in the nursing homes.INTERVENTION: Influenza vaccine was administered to volunteer staff after a face-to-face interview. No intervention took place in control nursing homes.MEASUREMENTS: The primary endpoint was total mortality rate in residents from 2 weeks before to 2 weeks after the influenza epidemic in the community. Secondary endpoints were rates of hospitalization and influenza-like illness (ILI) in residents and sick leave from work in staff.RESULTS: Staff influenza vaccination rates were 69.9% in the vaccination arm versus 31.8% in the control arm. Primary unadjusted analysis did not show significantly lower mortality in residents in the vaccination arm (odds ratio = 0.86, P = .08), although multivariate-adjusted analysis showed 20% lower mortality (P = .02), and a strong correlation was observed between staff vaccination coverage and all-cause mortality in residents (correlation coefficient = -0.42, P = .007). In the vaccination arm, significantly lower resident hospitalization rates were not observed, but ILI in residents was 31% lower (P = .007), and sick leave from work in staff was 42% lower (P = .03).CONCLUSION: These results support influenza vaccination of staff caring for institutionalized elderly people. J Am Geriatr Soc 57:1580-1586, 2009.