title: [Vaccination coverage against Streptococcus pneumoniae in splenectomized patients in a fourth-level hospital (1999-2004)].
abstract: BACKGROUND
  Patients in whom the spleen has been removed have a higher risk of acquiring infection by capsulated microorganisms, particularly Streptococcus pneumoniae, Haemophilus influenzae type b, and Neisseria meningitidis.
  
  
  OBJECTIVE
  Determine the vaccination coverage against S. pneumoniae of splenectomized patients in Hospital Clínico San Carlos (HCSC, Madrid) and to identify variables related to the level of vaccination coverage reached.
  
  
  METHODS
  From January 1, 1999 to December 31, 2004, a retrospective cohort study of all splenectomized patients was carried out in HCSC. Patients were identified from the Medical Records Department and the vaccination registry of the Preventive Medicine Service.
  
  
  RESULTS
  During the study period, 248 splenectomies were carried out. The median age was 61.0 years (interquartile range, 39.0-71.0). The most frequent reason for splenectomy was malignant gastrointestinal neoplasm (34.7%). Overall vaccination coverage against S. pneumoniae for the period studied was 48.4%. A significant increase in vaccination coverage per year was observed (P < .001). Multivariate analysis identified the following variables associated with a greater risk of not being vaccinated: male sex, patients proceeding from surgical services, and patients undergoing splenectomy during 1999 to 2001.
  
  
  CONCLUSIONS
  Vaccination coverage has increased every year since implementation of the protocol. Nevertheless, it necessary to extend the vaccination program within daily clinical practice.
authors.affiliation: Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, España. nolypg@yahoo.es
authors.forename: Manuel Enrique
authors.initials: ME
authors.lastname: Fuentes-Ferrer
authors.forename: Sara
authors.initials: S
authors.lastname: Cano-Escudero
authors.forename: Gloria
authors.initials: G
authors.lastname: Mato-Chaín
authors.forename: Alberto
authors.initials: A
authors.lastname: Mariano-Lázaro
authors.forename: José
authors.initials: J
authors.lastname: Fereres-Castiel
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines; D012189:Retrospective Studies; D013156:Splenectomy; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D022242:Pneumococcal Vaccines