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Influenza vaccination and risk of respiratory failure in patients with chronic obstructive pulmonary disease: A nationwide population-based case-cohort study.
J Microbiol Immunol Infect. 2019 Feb; 52(1):22-29.JM

Abstract

BACKGROUND

Chronic 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.

METHODS

From 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.

RESULTS

The 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.

CONCLUSIONS

Influenza 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.

Authors+Show Affiliations

Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Infectious Diseases, Department of Medicine, Taipei City Hospital, Zhongxiao Branch, Taiwan.Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Medicine, Taipei Veterans General Hospital, Su-Ao and Yuan-Shan Branch, I-Lan, Taiwan; Institute of Public Health and School of Medicine, National Yang-Ming University, Taipei, Taiwan.Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, Cardiovascular Research Center, National Yang-Ming University, Taiwan.Institute of Public Health and School of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Internal Medicine, National Yang-Ming University Hospital, I-Lan, Taiwan.Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.Community Medicine Research Center, Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.Division of Infectious Diseases, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Public Health and School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address: fdwang@vghtpe.gov.tw.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28927683

Citation

Huang, Hsin-Hui, et al. "Influenza Vaccination and Risk of Respiratory Failure in Patients With Chronic Obstructive Pulmonary Disease: a Nationwide Population-based Case-cohort Study." Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, vol. 52, no. 1, 2019, pp. 22-29.
Huang HH, Chen SJ, Chao TF, et al. Influenza vaccination and risk of respiratory failure in patients with chronic obstructive pulmonary disease: A nationwide population-based case-cohort study. J Microbiol Immunol Infect. 2019;52(1):22-29.
Huang, H. H., Chen, S. J., Chao, T. F., Liu, C. J., Chen, T. J., Chou, P., & Wang, F. D. (2019). Influenza vaccination and risk of respiratory failure in patients with chronic obstructive pulmonary disease: A nationwide population-based case-cohort study. Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi, 52(1), 22-29. https://doi.org/10.1016/j.jmii.2017.08.014
Huang HH, et al. Influenza Vaccination and Risk of Respiratory Failure in Patients With Chronic Obstructive Pulmonary Disease: a Nationwide Population-based Case-cohort Study. J Microbiol Immunol Infect. 2019;52(1):22-29. PubMed PMID: 28927683.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Influenza vaccination and risk of respiratory failure in patients with chronic obstructive pulmonary disease: A nationwide population-based case-cohort study. AU - Huang,Hsin-Hui, AU - Chen,Su-Jung, AU - Chao,Tze-Fan, AU - Liu,Chia-Jen, AU - Chen,Tzeng-Ji, AU - Chou,Pesus, AU - Wang,Fu-Der, Y1 - 2017/09/06/ PY - 2017/04/28/received PY - 2017/08/20/revised PY - 2017/08/27/accepted PY - 2017/9/21/pubmed PY - 2019/9/13/medline PY - 2017/9/21/entrez KW - Chronic obstructive pulmonary disease KW - Influenza KW - Respiratory failure KW - Taiwan National Health Insurance Research Database KW - Vaccine SP - 22 EP - 29 JF - Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi JO - J Microbiol Immunol Infect VL - 52 IS - 1 N2 - BACKGROUND: Chronic 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. METHODS: From 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. RESULTS: The 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. CONCLUSIONS: Influenza 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. SN - 1995-9133 UR - https://www.unboundmedicine.com/medline/citation/28927683/Influenza_vaccination_and_risk_of_respiratory_failure_in_patients_with_chronic_obstructive_pulmonary_disease:_A_nationwide_population_based_case_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1684-1182(17)30197-4 DB - PRIME DP - Unbound Medicine ER -