An emergency department-based pneumococcal vaccination program could save money and lives.
Pneumococcal vaccination (PV) rates for eligible emergency department patients are less than 25%. This study determines the potential effect of an ED-based pneumococcal vaccination program in preventing pneumococcal bacteremia (PB) in high-risk patients.
In a retrospective observational study, hospital records of 188 consecutive adults (>=18 years old) with PB were reviewed to determine how many were treated in the ED from 1 to 72 months before their admission for bacteremia.
Potential cost savings and mortality reductions from an ED-based PV program were calculated assuming PV prevents 65% of bacteremic episodes.
A retrospective review of 10,650 ED charts determined the percentage of patients with PV indications and the relative frequency of indications.
One hundred four (55%) of the 188 patients with PB were seen in the ED less than or equal to 72 months before their admission for PB, and 91 (88%) of the 104 had indications for PV.
These 91 patients had been evaluated in the ED an average of 3.4 times per patient during this 72-month period.
Nine patients (10%) died before discharge
Mean hospital stay for the 82 survivors was 11.2 days.
Of 10,650 ED charts reviewed, 2,011 (19%) had documented PV indications.
Most prevalent PV indications were age 65 years or older (851 patients, 42%), diabetes mellitus (697,35%), malignancy (248,12%), chronic renal failure (228,11%), and immunosuppression (221,11%). (...)
Mots-clés Pascal : Bactériémie, Bactériose, Infection, Streptococcus pneumoniae, Streptococcaceae, Micrococcales, Bactérie, Risque élevé, Vaccination, Service urgence, Coût, Mortalité, Pronostic, Prévention, Programme sanitaire, Médecine préventive, Adulte, Homme, Indication, Pneumococcie, Streptococcie, Economie santé
Mots-clés Pascal anglais : Bacteremia, Bacteriosis, Infection, Streptococcus pneumoniae, Streptococcaceae, Micrococcales, Bacteria, High risk, Vaccination, Emergency department, Costs, Mortality, Prognosis, Prevention, Sanitary program, Preventive medicine, Adult, Human, Indication, Pneumococcal infection, Streptococcal infection, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0233539
Code Inist : 002B30A03B. Création : 16/11/1999.