Asthma and influenza vaccination in elderly hospitalized patients: Matched case-control study in Spain
Por:
Suárez-Varela MM, Llopis A, Fernandez-Fabrellas E, Sanz F, Perez-Lozano MJ, Martin V, Astray J, Castilla J, Egurrola M, Force L, Toledo D and Domínguez À
Publicada:
1 ene 2018
Ahead of Print:
21 jun 2017
Resumen:
Objectives: Influenza infection is an exacerbating factor for asthma, and its prevention is critical in managing asthmatic patients. We investigated the effect of influenza vaccination on asthmatic and non-asthmatic patients hospitalized with laboratory-confirmed influenza in Spain. Methods: We made a matched case-control study to assess the frequency of hospitalization for influenza in people aged >= 65 years. Hospitalized patients with unplanned hospital admissions were recruited from 20 hospitals representing seven Spanish regions. Cases were defined as those hospitalized due to a laboratory-confirmed influenza infection and controls were matched by age, sex, and hospital. Data were obtained from clinical records, and patients stratified by clinical asthma history. Vaccination status and asthma due to influenza infection were analyzed according to sociodemographic variables and medical risk conditions. Multivariable analysis was made using conditional logistic regression models. Results: 582 hospitalized patients with influenza (15.8% asthmatic) and 1,570 hospitalized patients without influenza (7.9%asthmatic) were included. In the multivariable conditional logistic regression using unvaccinated and non-asthmatic patients as the reference group, vaccination significantly prevented influenza in non-asthmatic patients (aOR = 0.63; 95% CI: 0.45, 0.88) and also showed a trend for a possibly protective effect in asthmatic patients (aOR = 0.79; 95% CI: 0.34,1.81). Conclusion: Our results suggest that influenza vaccination could be a protective factor for asthmatic patients, although the results are inconclusive and further research is required. Practically, given the better clinical evolution of vaccinated asthma cases, and the lack of better evidence, the emphasis on vaccination of this group should continue.
Filiaciones:
:
c Centro Superior de Investigación en Salud Pública (CSISP) , Valencia , Spain
:
c Centro Superior de Investigación en Salud Pública (CSISP) , Valencia , Spain
Fernandez-Fabrellas E:
d Hospital General Universitario , Valencia , Spain
Sanz F:
d Hospital General Universitario , Valencia , Spain
Perez-Lozano MJ:
e Servicio de Medicina Preventiva , Hospital Universitario del Valme , Sevilla, Andalucia , Spain
Martin V:
f Área de Medicina Preventiva y Salud Publica, Departamento de Ciencias Biomédicas , Universidad de León , León , Spain
Astray J:
g Subdirección General de Epidemiologia de la Comunidad de Madrid , Madrid , Spain
Castilla J:
h Instituto de Investigación Sanitaria de Navarra (IdiSNA) , Recinto de Complejo Hospitalario de Navarra C/Irunlarrea , Pamplona, Navarra , Spain
Egurrola M:
i Servicio de Inmunología , Hospital de Galdakao-Usansolo , Usansolo, Vizcaya , Spain
Force L:
j Hospital de Mataró , Mataró, Barcelona , Spain
Toledo D:
k Departamento de Salud Pública , Universidad de Barcelona , Barcelona , Spain
Domínguez À:
k Departamento de Salud Pública , Universidad de Barcelona , Barcelona , Spain
|