Meta-analysis of efficacy of pneumococcal vaccination in patients with chronic obstructive pulmonary disease

Objective To systematically evaluate the efficacy of pneumococcal vaccine in patients with chronic obstructive pulmonary disease, providing evidence-based evidence for the prevention and treatment of chronic obstructive pulmonary disease. Methods We retrieved the randomized controlled research literature about pneumococcal vaccine efficacy of patients with chronic obstructive pulmonary disease from Cochrane library, Pubmed, Weipu database (VIP), China journal full-text database (CNKI) and WANFANG med online. Two researchers extracted data from the included research literature. The extracted contents included the study site, years of follow-up, interventions, and outcome measures (number of acute attacks, days of hospitalization, and interval between attacks). The Cochrane Collaboration Network bias risk assessment criteria were used to evaluate the quality of the included literature. Meta data analysis was made by RevMan 5.3 software. The standardized mean difference was used as the combined statistic. Hypothesis testing of combined statistics used 95% confidence interval, with Chi-square test for heterogeneity test. Results Nine studies were included, which are the Chinese research literatures. According to the results of the heterogeneity test of the three outcomes (P<0.050), with the random effects model for Meta analysis, the results of Meta analysis showed that pneumococcal vaccination of patients with chronic obstructive pulmonary disease in acute attack times[SMD=-5.070, 95% CI (-8.900,-1.230), P=0.010] and hospitalization days[SMD=-2.560,95% CI (-3.620,-1.500), P<0.001] were lower than patients without pneumococcal vaccination,and the difference was statistically significant. The duration of the attack was longer than that of patients who were not vaccinated with pneumococcal vaccine[SMD=1.040, 95% CI (0.850,1.230), P<0.001], and the difference was statistically significant. Conclusion Pneumococcal vaccine could effectively reduce the number of attacks and average hospitalization days in patients with chronic obstructive pulmonary disease, and extend the onset time interval. Pneumococcal vaccine was suggested to be used in patients with chronic obstructive pulmonary disease.