Influenza vaccination and risk of respiratory failure in patients with chronic obstructive pulmonary disease: A nationwide population-based case-cohort study |
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Authors: | Hsin-Hui Huang Su-Jung Chen Tze-Fan Chao Chia-Jen Liu Tzeng-Ji Chen Pesus Chou Fu-Der Wang |
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Affiliation: | 1. Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;2. Division of Infectious Diseases, Department of Medicine, Taipei City Hospital, Zhongxiao Branch, Taiwan;3. Department of Medicine, Taipei Veterans General Hospital, Su-Ao and Yuan-Shan Branch, I-Lan, Taiwan;4. Institute of Public Health and School of Medicine, National Yang-Ming University, Taipei, Taiwan;5. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;6. Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;7. Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan;8. Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan;9. Department of Internal Medicine, National Yang-Ming University Hospital, I-Lan, Taiwan;10. Community Medicine Research Center, Institute of Public Health, National Yang-Ming University, Taipei, Taiwan |
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Abstract: | BackgroundChronic obstructive pulmonary disease (COPD) is a chronic inflammatory disease which causes a considerable disease burden. Patients with COPD are at a higher risk for influenza infection and influenza vaccination are recommended at this high risk patient group. In the current study, we aimed to evaluate the association between influenza vaccination and the risk of respiratory failure (RF) in COPD patients.MethodsFrom 2001 to 2005, patients with newly diagnosed COPD were identified from the NHIRD, and were followed until 2010. We explored the influenza vaccination rate among this COPD cohort. Furthermore, patients who experienced RF were defined as case group, whereas the others were defined as control group. Baseline characteristic were compared and association between influenza vaccination and RF were evaluated.ResultsThe rate of influenza vaccination was significantly higher in patients age ≥65 years than those age <65 years (54.8% vs. 4%, p < 0.001). The vaccine cohort had more comorbidities, more health care utilization and more frequent acute exacerbations as compared with nonvaccine cohort. In multivariable logistic regression, influenza vaccination was associated with a reduced risk of respiratory failure (adjusted odds ratio [aOR] 0.87, 95% confidence interval [CI] 0.79–0.96). In subgroup analysis, we found that the association was insignificant in patients age <65 years, patients with relatively unstable disease status and patient did not receive influenza vaccination annually.ConclusionsInfluenza vaccination was associated with a decreased risk of RF in patients with COPD. Recommendation of annual influenza vaccination should be made when managing this high-risk patient group. |
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Keywords: | Influenza Vaccine Respiratory failure Chronic obstructive pulmonary disease Taiwan National Health Insurance Research Database |
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