Abstract

Background and aims: The effects of influenza vaccination (IV) on stroke outcomes are unclear. The purpose of this study is to evaluate the outcomes after stroke in elderly individuals who have received an IV. Methods: We used Taiwan's National Health Insurance Research Database 2000–2009 claims data to conduct a nested stroke cohort study including 148,909 hospitalized stroke patients aged 66 years and older. Using a matching procedure by propensity score, we selected 25,248 stroke patients with IV and 25,248 stroke patients without IV for comparison. Logistic regression was used to calculate the odds ratios (ORs) and 95% CIs of post-stroke complications and in-hospital mortality associated with IV. Results: Stroke patients with IV had significantly lower risks of post-stroke pneumonia (OR = 0.79; 95% CI, 0.74–0.83), septicemia (OR = 0.78; 95% CI, 0.70–0.86), urinary tract infection (OR = 0.87; 95% CI, 0.83–0.92), and 30-day in-hospital mortality (OR = 0.60; 95% CI, 0.54–0.67) compared with non-IV stroke patients. Vaccinated stroke patients also had shorter hospital stays (p < 0.0001) and less medical expenditures (p < 0.0001) during stroke admission than the control group. Lower rates of post-stroke adverse events in patients with IV were noted in both sexes of all age groups with various types of stroke. Conclusions: Stroke patients with IV showed fewer complications and lower mortality compared with non-IV patients. These findings suggest the urgent need to promote IV for this susceptible population of stroke patients.

Original languageEnglish
Pages (from-to)85-90
Number of pages6
JournalAtherosclerosis
Volume282
DOIs
Publication statusPublished - Mar 1 2019

Fingerprint

Geriatrics
Human Influenza
Vaccination
Cohort Studies
Stroke
Odds Ratio
Hospital Mortality
Propensity Score
National Health Programs
Health Expenditures
Taiwan
Urinary Tract Infections
Length of Stay
Sepsis
Pneumonia
Age Groups

Keywords

  • Infectious diseases
  • Influenza vaccination
  • Mortality
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

@article{8748c9bcda8a44498c971c3e5b657576,
title = "Protective effect of influenza vaccination on outcomes in geriatric stroke patients: A nationwide matched cohort study",
abstract = "Background and aims: The effects of influenza vaccination (IV) on stroke outcomes are unclear. The purpose of this study is to evaluate the outcomes after stroke in elderly individuals who have received an IV. Methods: We used Taiwan's National Health Insurance Research Database 2000–2009 claims data to conduct a nested stroke cohort study including 148,909 hospitalized stroke patients aged 66 years and older. Using a matching procedure by propensity score, we selected 25,248 stroke patients with IV and 25,248 stroke patients without IV for comparison. Logistic regression was used to calculate the odds ratios (ORs) and 95{\%} CIs of post-stroke complications and in-hospital mortality associated with IV. Results: Stroke patients with IV had significantly lower risks of post-stroke pneumonia (OR = 0.79; 95{\%} CI, 0.74–0.83), septicemia (OR = 0.78; 95{\%} CI, 0.70–0.86), urinary tract infection (OR = 0.87; 95{\%} CI, 0.83–0.92), and 30-day in-hospital mortality (OR = 0.60; 95{\%} CI, 0.54–0.67) compared with non-IV stroke patients. Vaccinated stroke patients also had shorter hospital stays (p < 0.0001) and less medical expenditures (p < 0.0001) during stroke admission than the control group. Lower rates of post-stroke adverse events in patients with IV were noted in both sexes of all age groups with various types of stroke. Conclusions: Stroke patients with IV showed fewer complications and lower mortality compared with non-IV patients. These findings suggest the urgent need to promote IV for this susceptible population of stroke patients.",
keywords = "Infectious diseases, Influenza vaccination, Mortality, Stroke",
author = "Fai Lam and Chen, {Ta Liang} and Shih, {Chun Chuan} and Lin, {Chao Shun} and Yeh, {Chun Chieh} and Lee, {Yuarn Jang} and Hu, {Chaur Jong} and Chiou, {Hung Yi} and Liao, {Chien Chang}",
year = "2019",
month = "3",
day = "1",
doi = "10.1016/j.atherosclerosis.2019.01.008",
language = "English",
volume = "282",
pages = "85--90",
journal = "Atherosclerosis",
issn = "0021-9150",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Protective effect of influenza vaccination on outcomes in geriatric stroke patients

T2 - A nationwide matched cohort study

AU - Lam, Fai

AU - Chen, Ta Liang

AU - Shih, Chun Chuan

AU - Lin, Chao Shun

AU - Yeh, Chun Chieh

AU - Lee, Yuarn Jang

AU - Hu, Chaur Jong

AU - Chiou, Hung Yi

AU - Liao, Chien Chang

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background and aims: The effects of influenza vaccination (IV) on stroke outcomes are unclear. The purpose of this study is to evaluate the outcomes after stroke in elderly individuals who have received an IV. Methods: We used Taiwan's National Health Insurance Research Database 2000–2009 claims data to conduct a nested stroke cohort study including 148,909 hospitalized stroke patients aged 66 years and older. Using a matching procedure by propensity score, we selected 25,248 stroke patients with IV and 25,248 stroke patients without IV for comparison. Logistic regression was used to calculate the odds ratios (ORs) and 95% CIs of post-stroke complications and in-hospital mortality associated with IV. Results: Stroke patients with IV had significantly lower risks of post-stroke pneumonia (OR = 0.79; 95% CI, 0.74–0.83), septicemia (OR = 0.78; 95% CI, 0.70–0.86), urinary tract infection (OR = 0.87; 95% CI, 0.83–0.92), and 30-day in-hospital mortality (OR = 0.60; 95% CI, 0.54–0.67) compared with non-IV stroke patients. Vaccinated stroke patients also had shorter hospital stays (p < 0.0001) and less medical expenditures (p < 0.0001) during stroke admission than the control group. Lower rates of post-stroke adverse events in patients with IV were noted in both sexes of all age groups with various types of stroke. Conclusions: Stroke patients with IV showed fewer complications and lower mortality compared with non-IV patients. These findings suggest the urgent need to promote IV for this susceptible population of stroke patients.

AB - Background and aims: The effects of influenza vaccination (IV) on stroke outcomes are unclear. The purpose of this study is to evaluate the outcomes after stroke in elderly individuals who have received an IV. Methods: We used Taiwan's National Health Insurance Research Database 2000–2009 claims data to conduct a nested stroke cohort study including 148,909 hospitalized stroke patients aged 66 years and older. Using a matching procedure by propensity score, we selected 25,248 stroke patients with IV and 25,248 stroke patients without IV for comparison. Logistic regression was used to calculate the odds ratios (ORs) and 95% CIs of post-stroke complications and in-hospital mortality associated with IV. Results: Stroke patients with IV had significantly lower risks of post-stroke pneumonia (OR = 0.79; 95% CI, 0.74–0.83), septicemia (OR = 0.78; 95% CI, 0.70–0.86), urinary tract infection (OR = 0.87; 95% CI, 0.83–0.92), and 30-day in-hospital mortality (OR = 0.60; 95% CI, 0.54–0.67) compared with non-IV stroke patients. Vaccinated stroke patients also had shorter hospital stays (p < 0.0001) and less medical expenditures (p < 0.0001) during stroke admission than the control group. Lower rates of post-stroke adverse events in patients with IV were noted in both sexes of all age groups with various types of stroke. Conclusions: Stroke patients with IV showed fewer complications and lower mortality compared with non-IV patients. These findings suggest the urgent need to promote IV for this susceptible population of stroke patients.

KW - Infectious diseases

KW - Influenza vaccination

KW - Mortality

KW - Stroke

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U2 - 10.1016/j.atherosclerosis.2019.01.008

DO - 10.1016/j.atherosclerosis.2019.01.008

M3 - Article

VL - 282

SP - 85

EP - 90

JO - Atherosclerosis

JF - Atherosclerosis

SN - 0021-9150

ER -