Effectiveness of pneumococcal vaccination on hospitalization and death in the adult and older adult diabetic population: a systematic review

Diabetic patients are at a higher risk of getting pneumococcal disease and are therefore recommended to get vaccinated. The aim of our systematic review is the retrieval and analysis of all available evidence on the effect of pneumococcal vaccination on the risk of hospitalization and death in adult patients with diabetes. MEDLINEand EMBASE were searched from inception until January 2023. We included all studies investigating whether pneumococcal vaccination reduces the risk of dying or being hospitalized in diabetic patients. The Newcastle-Ottawa scale was used to assess risk of bias. Only two studies, encompassing a total of 68,246 subjects, were considered eligible for inclusion and of high quality. In both studies polysaccharide pneumococcal vaccination was associated with a reduction of the risk of hospitalization or death in adult diabetic patients (aHR: 0.76 in one study, aOR: 0.97 in the other one). However, in neither of the two included studies the lower risk was statistically significant. Further research is needed due to the potentially major clinical implications for diabetic patients. The results of this systematic review can serve as a foundation for future studies, indicating the importance of continuing research in this area to improve patient outcomes.

糖尿病患者罹患肺炎球菌性疾病的风险更高，因此推荐其接种相关疫苗。本系统综述的研究目的为检索并分析所有已发表的相关证据，以明确肺炎球菌疫苗接种对成年糖尿病患者住院与死亡风险的影响。本研究于建库时至2023年1月期间，检索了MEDLINE与EMBASE数据库。纳入所有探究肺炎球菌疫苗接种是否可降低糖尿病患者死亡或住院风险的研究。采用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale, NOS）对研究偏倚风险进行评估。最终仅有2项研究符合纳入标准且质量评级为高，共纳入68246名研究对象。两项研究均显示，肺炎球菌多糖疫苗接种可降低成年糖尿病患者的住院或死亡风险（其中一项研究的调整后风险比（adjusted hazard ratio, aHR）为0.76，另一项的调整后优势比（adjusted odds ratio, aOR）为0.97）。但两项研究中该风险降低的差异均未达到统计学显著性。鉴于该研究结果对糖尿病患者可能存在重要的临床意义，未来仍需开展更多相关研究。本系统综述的研究结果可为未来相关研究提供基础，同时凸显了持续开展该领域研究以改善患者转归的重要性。