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Effect of Influenza Vaccination Against Postoperative Pneumonia and Mortality for Geriatric Patients Receiving Major Surgery: A Nationwide Matched Stu

tetano

Editor, Senior Moderator
J Infect Dis. 2017 Dec 5. doi: 10.1093/infdis/jix616. [Epub ahead of print]
[h=1]Effect of Influenza Vaccination Against Postoperative Pneumonia and Mortality for Geriatric Patients Receiving Major Surgery: A Nationwide Matched Study.[/h] Liu WC[SUP]1,[/SUP][SUP]2[/SUP], Lin CS[SUP]2,[/SUP][SUP]3,[/SUP][SUP]4[/SUP], Yeh CC[SUP]5,[/SUP][SUP]6[/SUP], Wu HY[SUP]1,[/SUP][SUP]2[/SUP], Lee YJ[SUP]7[/SUP], Chung CL[SUP]8[/SUP], Cherng YG[SUP]1,[/SUP][SUP]2[/SUP], Chen TL[SUP]2,[/SUP][SUP]3,[/SUP][SUP]4[/SUP], Liao CC[SUP]1,[/SUP][SUP]2,[/SUP][SUP]3,[/SUP][SUP]4,[/SUP][SUP]9[/SUP].
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]Background:[/h] Limited information is available on the association between a influenza vaccination and postoperative outcomes.
[h=4]Methods:[/h] Using Taiwan's National Health Insurance Research Database reimbursement claims data from 2008 to 2013, we conducted a matched cohort study of 16,903 patients over age 66 who received influenza vaccinations and later underwent major surgery. Using propensity score matching procedure adjusted for socio-demographics, medical conditions, types of surgery and anesthesia, 16,903 controls who were not vaccinated were selected. Logistic regressions were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) of postoperative pneumonia and in-hospital mortality associated with influenza vaccination.
[h=4]Results:[/h] Patients receiving preoperative influenza vaccination showed less postoperative pneumonia (OR, 0.62; 95% CI, 0.58-0.66) and in-hospital mortality (OR, 0.47; 95% CI, 0.39-0.56) compared with unvaccinated patients in both sexes and every age group. Vaccinated surgical patients also had decreased risk of postoperative intensive care (OR, 0.56; 95% CI, 0.53-0.60), shorter hospital stays (P < .0001) and lower medical expenditures (P < .0001) than non-vaccinated controls.
[h=4]Conclusions:[/h] Vaccinated geriatric surgical patients showed lower risks of pneumonia and in-hospital mortality compared with unvaccinated patients undergoing similar major surgeries. Further studies are needed to explain how preoperative influenza vaccination improves perioperative outcomes.


[h=4]KEYWORDS:[/h] Influenza vaccination; mortality; pneumonia; surgery

PMID: 29216345 DOI: 10.1093/infdis/jix616
 
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