School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan.
Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan.
Clin Interv Aging. 2019 Nov 26;14:2085-2093. doi: 10.2147/CIA.S228324. eCollection 2019.
Urticaria is a mast cell-related disease caused severe itching and the lifetime prevalence of urticaria is about 20% in general population. Our purpose is to evaluate risk of urticaria in geriatric stroke patients received influenza vaccination (IV).
In a cohort of 192,728 patients with newly diagnosed stroke aged over 65 years obtained from 23 million people in Taiwan's National Health Insurance between 2000 and 2008, we identified 9890 stroke patients who received IV and 9890 propensity score-matched stroke patients who did not receive IV. Controlling for immortal time bias, both the IV and non-IV groups were followed for one year. Urticaria events were identified during the follow-up period. We calculated the adjusted rate ratios (RRs) and 95% confidence intervals (CIs) of the one-year risk of urticaria associated with IV.
During the follow-up period of one year, stroke patients with IV had a significantly higher risk of urticaria compared with non-IV stroke patients (RR 1.81, 95% CI 1.47-2.23). An increased risk of urticaria in stroke patients with IV was noted in both sexes, patients 65-84 years of age, patients with comorbid medical conditions, and various time intervals of follow-up. Vaccinated stroke patients with hemorrhage (RR 4.00, 95% CI 1.76-9.10) and those who received intensive care (RR 5.14, 95% CI 2.32-11.4) had a very high risk of urticaria compared with those without IV.
Receiving IV may be associated with an increased risk of urticaria in stroke patients. We could not infer the causality from the current results because of this study's limitations. Future investigations are needed to evaluate the possible mechanism underlying the association between IV and urticaria.
荨麻疹是一种与肥大细胞相关的疾病，可引起严重瘙痒，其终生患病率在一般人群中约为 20%。我们的目的是评估老年中风患者接受流感疫苗接种（IV）后发生荨麻疹的风险。
在一项从 2000 年至 2008 年台湾全民健康保险系统中获得的 2300 万人中，年龄在 65 岁以上的新诊断为中风的 192728 名患者队列中，我们确定了 9890 名接受 IV 的中风患者和 9890 名接受倾向评分匹配但未接受 IV 的中风患者。为了控制不朽时间偏差，IV 组和非 IV 组都随访了一年。在随访期间确定了荨麻疹事件。我们计算了与 IV 相关的一年内荨麻疹风险的调整后率比（RR）和 95%置信区间（CI）。
在一年的随访期间，接受 IV 的中风患者发生荨麻疹的风险明显高于未接受 IV 的中风患者（RR 1.81，95%CI 1.47-2.23）。在两性、65-84 岁的患者、患有合并症的患者以及各种随访时间间隔中，接受 IV 的中风患者的荨麻疹风险均增加。与未接受 IV 的患者相比，接受出血的接种中风患者（RR 4.00，95%CI 1.76-9.10）和接受重症监护的患者（RR 5.14，95%CI 2.32-11.4）发生荨麻疹的风险非常高。
接受 IV 可能与中风患者荨麻疹的风险增加有关。由于本研究的局限性，我们不能从当前结果中推断出因果关系。未来的研究需要评估 IV 与荨麻疹之间关联的可能机制。
