title: Influence of prior pneumococcal and influenza vaccination on outcomes of older adults with community-acquired pneumonia.
abstract: OBJECTIVE
  To determine whether prior pneumococcal and seasonal influenza vaccination improves outcomes in older adults hospitalized for community-acquired pneumonia (CAP).
  
  
  METHODS
  Prospective, observational, multicenter study.
  
  
  METHODS
  Five public hospitals providing universal free care to the whole population in three Spanish regions.
  
  
  METHODS
  Individuals aged 65 and older admitted to the hospital with CAP through the emergency department.
  
  
  METHODS
  Pneumococcal and influenza vaccination status. The primary study outcomes were intensive care unit (ICU) admission, length of hospital stay (LOS), and overall case-fatality rate. Outcome variables of individuals vaccinated with both vaccines were compared with outcomes of those who were unvaccinated.
  
  
  RESULTS
  Two hundred thirty-eight individuals had received 23-valent pneumococcal polysaccharide vaccine and seasonal influenza vaccination and were compared with 195 unvaccinated individuals. No differences were found with respect to combined antibiotic therapy between groups (38.0% vs 39.7%; P = .80). Similar percentages of vaccinated and unvaccinated individuals required ICU admission (7.2% vs 8.2%; P = .69). Mean LOS was significantly shorter in vaccinated individuals (9.9 vs 12.4 days; P = .04). Overall case-fatality rates were similar in both groups (5.9% vs 5.1%; P = .73). After adjustment, LOS, risk of ICU admission, and overall case-fatality rate were not associated with prior pneumococcal and seasonal influenza vaccination.
  
  
  CONCLUSIONS
  The clinical outcomes of vaccinated older adults hospitalized with CAP were not better than those observed in unvaccinated individuals.
authors.affiliation: Department of Infectious Diseases, Bellvitge Biomedical Research Institute-Hospital Universitari de Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Adriana
authors.initials: A
authors.lastname: Manzur
authors.forename: Conchita
authors.initials: C
authors.lastname: Izquierdo
authors.forename: Laura
authors.initials: L
authors.lastname: Ruiz
authors.forename: Dolores
authors.initials: D
authors.lastname: Sousa
authors.forename: Jose-María
authors.initials: JM
authors.lastname: Bayas
authors.forename: Jose-Miguel
authors.initials: JM
authors.lastname: Celorrio
authors.forename: Wenceslao
authors.initials: W
authors.lastname: Varona
authors.forename: Manel
authors.initials: M
authors.lastname: Nebot
authors.forename: Lluis
authors.initials: L
authors.lastname: Salleras
authors.forename: Angela
authors.initials: A
authors.lastname: Domínguez
authors.forename: Jordi
authors.initials: J
authors.lastname: Carratalà
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007252:Influenza Vaccines; D008297:Male; D017063:Outcome Assessment, Health Care; D022242:Pneumococcal Vaccines; D011014:Pneumonia / Q000453:epidemiology*; D011446:Prospective Studies; D012111:Residence Characteristics
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines