[Vaccination coverage against Streptococcus pneumoniae in splenectomized patients in a fourth-level hospital (1999-2004)].

INTRODUCTION: 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. AIMS: 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.