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Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD.

Abstract

BACKGROUND

Influenza and pneumococcal vaccination are recommended in patients with chronic obstructive pulmonary disease (COPD). A recent study from Tayside found a reduced risk of all-cause mortality with vaccination in patients with COPD. The Health Improvement Network (THIN) database was used to test this hypothesis in a different data source.

METHODS

The THIN database was searched for patients with COPD. Vaccination status against Pneumococcus and the annual influenza vaccination status were determined. Mortality rates were calculated in the periods December to March and April to November. Relative risks for the effect of vaccination on all-cause mortality were estimated by Poisson regression, adjusting for age, sex, year and serious co-morbidities.

RESULTS

177,120 patients with COPD (mean age 65 years) were identified, with a mean follow-up of 6.8 years between 1988 and 2006. Vaccination rates against influenza rose from <30% before 1995 to >70% in 2005 in patients aged 60 years or more. The cumulative vaccination rate against pneumonia rose from almost zero to 70% in patients aged 70 years or more over the same period. For all-cause mortality the adjusted relative risks associated with influenza vaccination were 0.59 (95% CI 0.57 to 0.61) during the influenza season and 0.97 (95% CI 0.94 to 1.00) outside the season in patients not vaccinated against pneumonia, and 0.30 (95% CI 0.28 to 0.32) and 0.98 (95% CI 0.96 to 1.11), respectively, in patients vaccinated against pneumonia. The relative risk associated with pneumococcal vaccination was >1 at all times of the year.

CONCLUSIONS

Influenza but not pneumococcal vaccination was associated with a reduced risk of all-cause mortality in COPD.

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  • Authors+Show Affiliations

    ,

    Medicines Monitoring Unit, Division of Medicine and Therapeutics, University of Dundee, Dundee DD1 9SY, UK. sschembri@nhs.net

    , ,

    Source

    Thorax 64:7 2009 Jul pg 567-72

    MeSH

    Adult
    Age Distribution
    Aged
    Aged, 80 and over
    Confounding Factors (Epidemiology)
    Female
    Humans
    Influenza Vaccines
    Influenza, Human
    Male
    Middle Aged
    Opportunistic Infections
    Pneumococcal Vaccines
    Pneumonia, Pneumococcal
    Pulmonary Disease, Chronic Obstructive
    Retrospective Studies
    Scotland
    Sex Distribution
    Vaccination

    Pub Type(s)

    Journal Article
    Multicenter Study

    Language

    eng

    PubMed ID

    19321465

    Citation

    Schembri, S, et al. "Influenza but Not Pneumococcal Vaccination Protects Against All-cause Mortality in Patients With COPD." Thorax, vol. 64, no. 7, 2009, pp. 567-72.
    Schembri S, Morant S, Winter JH, et al. Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD. Thorax. 2009;64(7):567-72.
    Schembri, S., Morant, S., Winter, J. H., & MacDonald, T. M. (2009). Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD. Thorax, 64(7), pp. 567-72. doi:10.1136/thx.2008.106286.
    Schembri S, et al. Influenza but Not Pneumococcal Vaccination Protects Against All-cause Mortality in Patients With COPD. Thorax. 2009;64(7):567-72. PubMed PMID: 19321465.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Influenza but not pneumococcal vaccination protects against all-cause mortality in patients with COPD. AU - Schembri,S, AU - Morant,S, AU - Winter,J H, AU - MacDonald,T M, Y1 - 2009/03/24/ PY - 2009/3/27/entrez PY - 2009/3/27/pubmed PY - 2009/8/8/medline SP - 567 EP - 72 JF - Thorax JO - Thorax VL - 64 IS - 7 N2 - BACKGROUND: Influenza and pneumococcal vaccination are recommended in patients with chronic obstructive pulmonary disease (COPD). A recent study from Tayside found a reduced risk of all-cause mortality with vaccination in patients with COPD. The Health Improvement Network (THIN) database was used to test this hypothesis in a different data source. METHODS: The THIN database was searched for patients with COPD. Vaccination status against Pneumococcus and the annual influenza vaccination status were determined. Mortality rates were calculated in the periods December to March and April to November. Relative risks for the effect of vaccination on all-cause mortality were estimated by Poisson regression, adjusting for age, sex, year and serious co-morbidities. RESULTS: 177,120 patients with COPD (mean age 65 years) were identified, with a mean follow-up of 6.8 years between 1988 and 2006. Vaccination rates against influenza rose from <30% before 1995 to >70% in 2005 in patients aged 60 years or more. The cumulative vaccination rate against pneumonia rose from almost zero to 70% in patients aged 70 years or more over the same period. For all-cause mortality the adjusted relative risks associated with influenza vaccination were 0.59 (95% CI 0.57 to 0.61) during the influenza season and 0.97 (95% CI 0.94 to 1.00) outside the season in patients not vaccinated against pneumonia, and 0.30 (95% CI 0.28 to 0.32) and 0.98 (95% CI 0.96 to 1.11), respectively, in patients vaccinated against pneumonia. The relative risk associated with pneumococcal vaccination was >1 at all times of the year. CONCLUSIONS: Influenza but not pneumococcal vaccination was associated with a reduced risk of all-cause mortality in COPD. SN - 1468-3296 UR - https://www.unboundmedicine.com/medline/citation/19321465/Influenza_but_not_pneumococcal_vaccination_protects_against_all_cause_mortality_in_patients_with_COPD_ L2 - http://thorax.bmj.com/cgi/pmidlookup?view=long&amp;pmid=19321465 DB - PRIME DP - Unbound Medicine ER -