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

Chao-Shun Lin; Chuen-Chau Chang; Chun-Chieh Yeh; Yi-Cheng Chang; Ta-Liang Chen; Chien-Chang Liao

doi:10.1016/j.diabres.2022.109930

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

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

Authors

Chao-Shun Lin¹, Chuen-Chau Chang¹, Chun-Chieh Yeh², Yi-Cheng Chang³, Ta-Liang Chen⁴, Chien-Chang Liao⁵

Affiliations

¹ 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.
² Department of Surgery, China Medical University Hospital, Taichung, Taiwan; Department of Surgery, University of Illinois, Chicago, IL, USA.
³ Division of Endocrinology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
⁴ 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 Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
⁵ 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; Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan. Electronic address: ccliao@tmu.edu.tw.

PMID: 35605799
DOI: 10.1016/j.diabres.2022.109930

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.

Keywords: Complications; Diabetes; Hospitalization; Influenza vaccination; Mortality.

MeSH terms

Cohort Studies
Diabetes Mellitus* / epidemiology
Hospitalization
Humans
Influenza, Human* / complications
Influenza, Human* / epidemiology
Influenza, Human* / prevention & control
Pneumonia* / complications
Pneumonia* / epidemiology
Vaccination