Department of Global Health, School of Public Health, Peking University, Beijing. China; Energy Saving & Environmental Protection & Occupational Safety and Health Research Institute, China Academy of Railway Sciences Co., Ltd, Beijing 100081, China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing. China.
Vaccine. 2024 Nov 14;42(25):126142. doi: 10.1016/j.vaccine.2024.07.043. Epub 2024 Jul 17.
In older populations admitted for diabetes, limited evidence suggests that influenza vaccination protects against hospitalization outcomes.
This study pooled 27,620 hospitalizations recorded for elderly diabetes patients from the Beijing Elderly Influenza Vaccination Information Registration Database (2013-2018) and the Beijing Urban Employee Basic Medical Insurance Database (2013-2018). Generalized linear regression and propensity score matching were conducted to estimate the effects of influenza vaccination on hospitalization outcomes (in-hospital all-cause mortality, readmission, length and costs of hospitalization), adjusting for measurable confounding factors. The low influenza period (May-July) was used as a reference period to adjust for unmeasured confounding factors during the peak influenza period (November-January).
In propensity score matching, influenza vaccination in peak influenza period could reduce the risk of in-hospital death (OR: 0.47[0.22,0.97]) and readmission (OR: 0.70[0.60,0.81]), length of hospitalization (β: -1.32[-1.47, -1.17]) and medical costs (GMR: 0.90[0.88,0.92]). After adjusting for unmeasured confounding factors, influenza vaccination was associated with 17% (ratio of ORs: 0.83 [0.69, 1.02]) lower risk of readmission and shorter length of hospitalization (difference in β: -0.23 [-0.62, 0.16]). The subgroup analyses showed that male patients with older age and poorer health conditions could benefit more after influenza vaccination.
Influenza vaccination could significantly improve hospitalization outcomes in elderly diabetic patients. This provides evidence supporting free influenza vaccination policies for vulnerable populations in low- and middle-income countries.
在因糖尿病住院的老年患者中，现有有限证据表明流感疫苗可预防住院结局。
本研究汇总了 2013 年至 2018 年期间北京老年流感疫苗信息登记数据库（BEIJING Elderly Influenza Vaccination Information Registration Database，BEIJING-EID）和北京市城镇职工基本医疗保险数据库（Beijing Urban Employee Basic Medical Insurance Database，BUEBMI）中记录的 27620 例老年糖尿病患者的住院资料。采用广义线性回归和倾向评分匹配来评估流感疫苗对住院结局（住院期间全因死亡率、再入院率、住院时间和住院费用）的影响，同时调整可衡量的混杂因素。将流感低发期（5 月至 7 月）作为参考期，以调整流感高发期（11 月至 1 月）期间未测量的混杂因素。
在倾向评分匹配中，流感高发期接种流感疫苗可降低住院期间死亡（OR：0.47[0.22，0.97]）和再入院（OR：0.70[0.60，0.81]）的风险，住院时间（β：-1.32[-1.47，-1.17]）和医疗费用（GMR：0.90[0.88，0.92]）。在校正未测量的混杂因素后，流感疫苗接种与再入院风险降低 17%（比值比（OR）：0.83[0.69，1.02]）和住院时间缩短（差值β：-0.23[-0.62，0.16]）有关。亚组分析显示，年龄较大和健康状况较差的男性患者接种流感疫苗后获益更多。
流感疫苗可显著改善老年糖尿病患者的住院结局。这为中低收入国家为弱势群体实施免费流感疫苗政策提供了证据支持。
