Chest
Pneumococcal Infection and Immunologic Response to Pneumococcal Vaccine in Chronic Obstructive Pulmonary Disease: A Pilot Study
Section snippets
MATERIALS AND METHODS
We studied 103 patients with COPD, which was diagnosed by clinical and pulmonary function criteria, from the Chest Clinics of Bellevue Hospital Center (90 patients) and the Manhattan Veterans Hospital (13 patients). Patients with reversible airflow obstruction were excluded in the absence of clinical chronic bronchitis (cough at least three months per year for three consecutive years) or emphysema, as judged by clinical, radiologic, and lung volume criteria. Patients with malignant neoplasms,
RESULTS
The 50 vaccinated patients did not differ significantly from the 53 placebo-injected patients in respect to diagnoses, age, or pulmonary functional impairment. All of the subjects had chronic bronchitis, emphysema, or asthmatic bronchitis and chronic airflow limitation. Similar numbers of patients in both groups also had cardiovascular disease, diabetes mellitus, or a history of excessive consumption of alcohol. The mean age of the group receiving placebo was 61±10 years and of those receiving
DISCUSSION
Our retrospective and prospective data confirm the generally held belief that patients with chronic airway obstruction have a relatively high incidence of pneumonia. As summarized in Table 8, our patients seemed to have more pneumonias than other outpatient groups16, 17 or the general US population,16, 18 but similar to elderly domiciled mental patients.16 This is not unexpected, as prior pulmonary disease19 and hospitalization within the past five years20 (common in these patients) have been
ACKNOWLEDGMENT
We thank Berton D. Freedman, and Walter Adam Wichern III, M.S., for statistical help and analysis of data; Marta Kane, R.N., and medical students Steven Bock, Michael Blum, and William Lee for research assistance; and Lillian Larrier, B.A., and Nancy Moldover, B.A., for microbiologic technical help.
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Supported in part by the National Institute of Allergy and Infectious Disease, the Stony-Wold Herbert Fund, Inc., and Eh Lilly and Co.
Manuscript received September 29; revision accepted January 27.