Influenza vaccination and the risk of all-cause death and cardiovascular event among Taiwanese elderly
Date Issued
2009
Date
2009
Author(s)
Ke, Shin-Rong
Abstract
Background: Influenza vaccination was reported to prevent all-cause death and hospitalization in the elderly. However, it is not clear whether influenza vaccination prevent acute cardiovascular events in this group. ethod: We conducted a retrospective, hospital based cohort study during the 2007-2008 to assess the influence of influenza vaccine on the risk of all cause death and cardiovascular events. The follow-up periods were influenza season and whole season. The information was collected by telephone survey and medical record. Cox proportional hazards model and propensity score matching were used for analysis.esult: A total of 445 vaccinated patient and 318 non-vaccinated patients were included in our study. Median follow-up time was 12 (interquartile range: 11-12) month. During the follow-up period, 31 cases of all-cause death and 75 cases of acute cardiovascular event were noted. Vaccination was associated with lower risk of all-cause death (in influenza season: hazard ratio 0.16, 95% confidence interval 0.045-0.57; in whole season: hazard ratio 0.15, 95% confidence interval 0.054-0.42). In cardiovascular event, vaccination was associated with non-significant risk reduction (in influenza season: hazard ratio 0.65, 95% confidence interval 0.33-1.28; in whole season: hazard ratio 0.81, 95% confidence interval 0.50-1.31). By propensity score 1:1 matching, 251 matched pairs in the vaccinated and non-vaccinated group were investigated. In all- cause death, vaccination was associated with significant risk reduction (in influenza season: hazard ratio 0.08; 95% confidence interval 0.01-0.59; in whole season: hazard ratio 0.1; 95% confidence interval 0.02-0.43). In cardiovascular events, vaccination was associated with non-significant risk reduction (in influenza season: hazard ratio 0.58, 95% confidence interval 0.23-1.48; in whole season: hazard ratio 0.64, 95% confidence interval 0.33-1.24). In the subgroup analysis, influenza vaccine showed a borderline protective effect on acute cardiovascular event in subjects with younger age (hazard ratio 0.31, 95% confidence interval 0.09-1.14) and preexisting cardiovascular disease (hazard ratio 0.57, 95% confidence interval 0.26-1.24) in the influenza season.onclusion: In the elderly, influenza vaccination reduced the risk of all- cause death both in influenza season and whole season. However, the vaccination did not have significant protective effect on cardiovascular event among elder ethnic Chinese.
Subjects
influenza vaccine
elderly
coronary artery disease
mortality
acute myocardial infarction
SDGs
Type
thesis
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