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Effectiveness of influenza vaccination in elderly diabetic patients: a retrospective cohort study.

Abstract

PURPOSE

Studies regarding the clinical benefits of influenza vaccination in diabetic patients are limited. This study evaluated if the elderly diabetic patients who have had influenza vaccination would have benefits such as reduced medical care and mortality.

METHODS

We used the universal insurance claims data from 2001 to 2009 in Taiwan to identify annual elderly patients with diabetes cohorts with (N=4454) and without (N=4571) influenza vaccination. The risk of developing pneumonia or influenza, respiratory failure, intensive care, hospitalization, and mortality were measured and compared between cohorts within one year of follow-up.

RESULTS

The vaccine cohort had lower incidences of pneumonia or influenza and respiratory failure compared with the non-vaccine cohort. More importantly, the vaccine cohort had a hospitalization rate that was 11% less than the non-vaccine cohort (29.6 vs. 33.1 per 100 person-years) with an adjusted hazard ratio (HR) of 0.88 (95% CI 0.81-0.96). The vaccine cohort was also less likely to be admitted to the intensive care unit (ICU) [0.58 vs. 2.05 per 100 person-year; adjusted HR 0.30 (95% CI 0.19-0.47)] and less likely to expire [3.13 vs. 7.96 per 100 person-year; adjusted HR 0.44 (95% CI 0.36-0.54)]. Influenza vaccination reduced the hospitalization cost by 1282.6 USD, compared with patients without influenza vaccination (95% CI -2210.3, -354.8).

CONCLUSION

Influenza vaccination is associated with a reduced risk of morbidity, hospitalization, ICU admissions, and mortality. In addition, the hospitalization cost is reduced.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan.

    , , , , , , , ,

    Source

    Vaccine 31:4 2013 Jan 11 pg 718-24

    MeSH

    Aged
    Aged, 80 and over
    Cohort Studies
    Diabetes Mellitus
    Female
    Hospitalization
    Humans
    Influenza Vaccines
    Influenza, Human
    Male
    Morbidity
    Retrospective Studies
    Survival Rate
    Taiwan
    Treatment Outcome
    Vaccination

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    23153445

    Citation

    Wang, I-Kuan, et al. "Effectiveness of Influenza Vaccination in Elderly Diabetic Patients: a Retrospective Cohort Study." Vaccine, vol. 31, no. 4, 2013, pp. 718-24.
    Wang IK, Lin CL, Chang YC, et al. Effectiveness of influenza vaccination in elderly diabetic patients: a retrospective cohort study. Vaccine. 2013;31(4):718-24.
    Wang, I. K., Lin, C. L., Chang, Y. C., Lin, P. C., Liang, C. C., Liu, Y. L., ... Sung, F. C. (2013). Effectiveness of influenza vaccination in elderly diabetic patients: a retrospective cohort study. Vaccine, 31(4), pp. 718-24. doi:10.1016/j.vaccine.2012.11.017.
    Wang IK, et al. Effectiveness of Influenza Vaccination in Elderly Diabetic Patients: a Retrospective Cohort Study. Vaccine. 2013 Jan 11;31(4):718-24. PubMed PMID: 23153445.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effectiveness of influenza vaccination in elderly diabetic patients: a retrospective cohort study. AU - Wang,I-Kuan, AU - Lin,Cheng-Li, AU - Chang,Yi-Chih, AU - Lin,Po-Chang, AU - Liang,Chih-Chia, AU - Liu,Yao-Lung, AU - Chang,Chiz-Tzung, AU - Yen,Tzung-Hai, AU - Huang,Chiu-Ching, AU - Sung,Fung-Chang, Y1 - 2012/11/12/ PY - 2012/09/03/received PY - 2012/10/22/revised PY - 2012/11/02/accepted PY - 2012/11/17/entrez PY - 2012/11/17/pubmed PY - 2013/7/13/medline SP - 718 EP - 24 JF - Vaccine JO - Vaccine VL - 31 IS - 4 N2 - PURPOSE: Studies regarding the clinical benefits of influenza vaccination in diabetic patients are limited. This study evaluated if the elderly diabetic patients who have had influenza vaccination would have benefits such as reduced medical care and mortality. METHODS: We used the universal insurance claims data from 2001 to 2009 in Taiwan to identify annual elderly patients with diabetes cohorts with (N=4454) and without (N=4571) influenza vaccination. The risk of developing pneumonia or influenza, respiratory failure, intensive care, hospitalization, and mortality were measured and compared between cohorts within one year of follow-up. RESULTS: The vaccine cohort had lower incidences of pneumonia or influenza and respiratory failure compared with the non-vaccine cohort. More importantly, the vaccine cohort had a hospitalization rate that was 11% less than the non-vaccine cohort (29.6 vs. 33.1 per 100 person-years) with an adjusted hazard ratio (HR) of 0.88 (95% CI 0.81-0.96). The vaccine cohort was also less likely to be admitted to the intensive care unit (ICU) [0.58 vs. 2.05 per 100 person-year; adjusted HR 0.30 (95% CI 0.19-0.47)] and less likely to expire [3.13 vs. 7.96 per 100 person-year; adjusted HR 0.44 (95% CI 0.36-0.54)]. Influenza vaccination reduced the hospitalization cost by 1282.6 USD, compared with patients without influenza vaccination (95% CI -2210.3, -354.8). CONCLUSION: Influenza vaccination is associated with a reduced risk of morbidity, hospitalization, ICU admissions, and mortality. In addition, the hospitalization cost is reduced. SN - 1873-2518 UR - https://www.unboundmedicine.com/medline/citation/23153445/Effectiveness_of_influenza_vaccination_in_elderly_diabetic_patients:_a_retrospective_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0264-410X(12)01610-6 DB - PRIME DP - Unbound Medicine ER -