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流感疫苗接种患者住院后糖尿病结局的观察:基于人群的队列研究。

Outcomes following diabetes admission in patients who had influenza vaccination: A population-based cohort study.

机构信息

Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.

Department of Surgery, China Medical University Hospital, Taichung, Taiwan; Department of Surgery, University of Illinois, Chicago, IL, USA.

出版信息

Diabetes Res Clin Pract. 2022 Jul;189:109930. doi: 10.1016/j.diabres.2022.109930. Epub 2022 May 21.

Abstract

OBJECTIVE

The beneficial effect of influenza vaccination (IV) in patients with diabetes was not completely understood.

METHODS

Using the research data of health insurance, we performed a cohort study of patients aged ≥20 years who were admitted to inpatient care due to diabetes in 2008-2013 in Taiwan. We performed the propensity score matching and the outcomes of complications and mortality following the diabetes admission was compared between patients with and without IV.

RESULTS

Among 61,002 patients with diabetes admission, IV reduced 30-day in-hospital mortality (odds ratio [OR] 0.75, 95% confidence interval [CI] 0.66-0.84), particularly among patients with prior diabetes hospitalization, inadequate control for diabetes, and diabetes-related comorbidities, such as eye involvement, ketoacidosis, renal manifestations, and coma. Compared with non-IV control group, patients with IV also had decreased risks of pneumonia (OR 0.92, 95% CI 0.87-0.97), septicemia (OR 0.83, 95% CI 0.79-0.88), urinary tract infection (OR 0.94, 95% CI 0.90-0.97), and intensive care (OR 0.29, 95% CI 0.27-0.31).

CONCLUSION

In patients with diabetes admission, IV was associated with reduced risks of complications and mortality. Our study implicated the urgent need to promote influenza vaccination for this susceptible population with diabetes.

摘要

目的

流感疫苗接种(IV)对糖尿病患者的有益效果尚未完全明确。

方法

我们利用健康保险的研究数据,对 2008 年至 2013 年间因糖尿病住院的年龄≥20 岁的患者进行了队列研究。我们进行了倾向评分匹配,并比较了接种组和未接种组患者在糖尿病住院后的并发症和死亡率。

结果

在 61002 例糖尿病住院患者中,IV 降低了 30 天院内死亡率(比值比 [OR] 0.75,95%置信区间 [CI] 0.66-0.84),尤其是在有既往糖尿病住院史、糖尿病控制不佳和糖尿病相关合并症(如眼部受累、酮症酸中毒、肾脏表现和昏迷)的患者中。与未接种 IV 的对照组相比,接种 IV 的患者发生肺炎(OR 0.92,95% CI 0.87-0.97)、败血症(OR 0.83,95% CI 0.79-0.88)、尿路感染(OR 0.94,95% CI 0.90-0.97)和重症监护(OR 0.29,95% CI 0.27-0.31)的风险也降低了。

结论

在糖尿病住院患者中,IV 与降低并发症和死亡率的风险相关。我们的研究表明迫切需要为这一易感人群(糖尿病患者)推广流感疫苗接种。

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