Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD
| Autor: | Joanne M. Langley, David B. Richardson, Scott A. Halperin, Makeda Semret, Daniel Smyth, Gael Dos Santos, Janet E. McElhaney, Bruce Light, Louis Valiquette, Guy Boivin, Todd F. Hatchette, Andre Poirier, Kevin Katz, Melissa K. Andrew, Philippe Lagacé-Wiens, Jennie Johnstone, Mark Loeb, Li Li, Sunita Mulpuru, Duncan Webster, Jeff Powis, Vivek Shinde, Jason J. LeBlanc, William R. Bowie, Barbara Ibarguchi, Ardith Ambrose, Shelly A. McNeil, François Haguinet, Gregory G. Taylor, Lingyun Ye, Karen Green, Ayman Chit, Donna MacKinnon-Cameron, Anne McCarthy, Stephanie L. Smith, May Elsherif, Allison McGeer, Sylvie Trottier |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine Canada medicine.medical_specialty Adolescent Exacerbation Hospitalized patients Comorbidity Critical Care and Intensive Care Medicine Logistic regression Risk Assessment Severity of Illness Index Pulmonary Disease Chronic Obstructive Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Influenza Human medicine Humans Prospective Studies 030212 general & internal medicine Aged COPD business.industry Vaccination Middle Aged Prognosis medicine.disease Hospitalization Survival Rate 030228 respiratory system Immunization Influenza A virus Influenza Vaccines Female Cardiology and Cardiovascular Medicine business Follow-Up Studies Cohort study |
| Zdroj: | Chest. 155:69-78 |
| ISSN: | 0012-3692 |
| Popis: | The effectiveness of influenza vaccination in reducing influenza-related hospitalizations among patients with COPD is not well described, and influenza vaccination uptake remains suboptimal.Data were analyzed from a national, prospective, multicenter cohort study including patients with COPD, hospitalized with any acute respiratory illness or exacerbation between 2011 and 2015. All patients underwent nasopharyngeal swab screening with polymerase chain reaction (PCR) testing for influenza. The primary outcome was an influenza-related hospitalization. We identified influenza-positive cases and negative control subjects and used multivariable logistic regression with a standard test-negative design to estimate the vaccine effectiveness for preventing influenza-related hospitalizations.Among 4,755 hospitalized patients with COPD, 4,198 (88.3%) patients with known vaccination status were analyzed. The adjusted analysis showed a 38% reduction in influenza-related hospitalizations in vaccinated vs unvaccinated individuals. Influenza-positive patients (n = 1,833 [38.5%]) experienced higher crude mortality (9.7% vs 7.9%; P = .047) and critical illness (17.2% vs 12.1%; P .001) compared with influenza-negative patients. Risk factors for mortality in influenza-positive patients included age75 years (OR, 3.7 [95% CI, 0.4-30.3]), cardiac comorbidity (OR, 2.0 [95% CI, 1.3-3.2]), residence in long-term care (OR, 2.6 [95% CI, 1.5-4.5]), and home oxygen use (OR, 2.9 [95% CI, 1.6-5.1]).Influenza vaccination significantly reduced influenza-related hospitalization among patients with COPD. Initiatives to increase vaccination uptake and early use of antiviral agents among patients with COPD could reduce influenza-related hospitalization and critical illness and improve health-care costs in this vulnerable population.ClinicalTrials.govNo.:NCT01517191; URL www.clinicaltrials.gov. |
| Databáze: | OpenAIRE |
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