Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD

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, hospi...

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Published inChest Vol. 155; no. 1; pp. 69 - 78
Main Authors Mulpuru, Sunita, Li, Li, Ye, Lingyun, Hatchette, Todd, Andrew, Melissa K., Ambrose, Ardith, Boivin, Guy, Bowie, William, Chit, Ayman, Dos Santos, Gael, ElSherif, May, Green, Karen, Haguinet, Francois, Halperin, Scott A., Ibarguchi, Barbara, Johnstone, Jennie, Katz, Kevin, Langley, Joanne M., LeBlanc, Jason, Loeb, Mark, MacKinnon-Cameron, Donna, McCarthy, Anne, McElhaney, Janet E., McGeer, Allison, Powis, Jeff, Richardson, David, Semret, Makeda, Shinde, Vivek, Smyth, Daniel, Trottier, Sylvie, Valiquette, Louis, Webster, Duncan, McNeil, Shelly A., Lagace-Wiens, Philippe, Light, Bruce, Poirier, Andre, Smith, Stephanie, Taylor, Gregory
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.01.2019
Subjects
COPD
hospitalization
influenza
pulmonary
vaccine effectiveness
influenza
vaccine effectiveness
COPDE
NP
hospitalization
SOS
pulmonary
PCR
COPD
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Abstract 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 age > 75 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
AbstractList The effectiveness of influenza vaccination in reducing influenza-related hospitalizations among patients with COPD is not well described, and influenza vaccination uptake remains suboptimal.BACKGROUNDThe 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.METHODSData 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 age > 75 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]).RESULTSAmong 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 age > 75 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.CONCLUSIONSInfluenza 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.TRIAL REGISTRYClinicalTrials.govNo.:NCT01517191; URL www.clinicaltrials.gov.
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 age > 75 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
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 age > 75 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.
Author Langley, Joanne M.
Taylor, Gregory
Poirier, Andre
Smith, Stephanie
Ambrose, Ardith
Light, Bruce
Webster, Duncan
Loeb, Mark
Halperin, Scott A.
Lagace-Wiens, Philippe
Boivin, Guy
Trottier, Sylvie
Katz, Kevin
Ibarguchi, Barbara
Powis, Jeff
Valiquette, Louis
Shinde, Vivek
Mulpuru, Sunita
Chit, Ayman
Dos Santos, Gael
LeBlanc, Jason
Hatchette, Todd
Haguinet, Francois
Li, Li
Johnstone, Jennie
Richardson, David
MacKinnon-Cameron, Donna
Ye, Lingyun
ElSherif, May
Andrew, Melissa K.
Bowie, William
McGeer, Allison
Smyth, Daniel
McNeil, Shelly A.
Green, Karen
McElhaney, Janet E.
McCarthy, Anne
Semret, Makeda
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/30616737$$D View this record in MEDLINE/PubMed
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Taylor, Gregory
Light, Bruce
Poirier, Andre
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Copyright 2018 American College of Chest Physicians
Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
Copyright_xml – notice: 2018 American College of Chest Physicians
– notice: Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
CorporateAuthor Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN)
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ISSN 0012-3692
1931-3543
IngestDate Thu Jul 10 23:09:39 EDT 2025
Thu Apr 03 07:03:45 EDT 2025
Tue Jul 01 02:55:55 EDT 2025
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IsPeerReviewed true
IsScholarly true
Issue 1
Keywords influenza
vaccine effectiveness
COPDE
NP
hospitalization
SOS
pulmonary
PCR
COPD
Language English
License Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.
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Snippet The effectiveness of influenza vaccination in reducing influenza-related hospitalizations among patients with COPD is not well described, and influenza...
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SubjectTerms COPD
hospitalization
influenza
pulmonary
vaccine effectiveness
Title Effectiveness of Influenza Vaccination on Hospitalizations and Risk Factors for Severe Outcomes in Hospitalized Patients With COPD
URI https://www.clinicalkey.com/#!/content/1-s2.0-S0012369218327259
https://dx.doi.org/10.1016/j.chest.2018.10.044
https://www.ncbi.nlm.nih.gov/pubmed/30616737
https://www.proquest.com/docview/2165060368
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