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

  • Chao-Shun Lin
    Affiliations
    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
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  • Chuen-Chau Chang
    Affiliations
    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
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  • Chun-Chieh Yeh
    Affiliations
    Department of Surgery, China Medical University Hospital, Taichung, Taiwan

    Department of Surgery, University of Illinois, Chicago, IL, USA
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  • Yi-Cheng Chang
    Affiliations
    Division of Endocrinology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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  • Author Footnotes
    1 Ta-Liang Chen has equal contribution with the corresponding author.
    Ta-Liang Chen
    Footnotes
    1 Ta-Liang Chen has equal contribution with the corresponding author.
    Affiliations
    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
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  • Chien-Chang Liao
    Correspondence
    Corresponding author at: Department of Anesthesiology, Taipei Medical University Hospital, 252 Wuxing St., Taipei 110, .
    Affiliations
    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
    Search for articles by this author
  • Author Footnotes
    1 Ta-Liang Chen has equal contribution with the corresponding author.

      Highlights

      • Influenza vaccination reduced mortality in patients with diabetes admission.
      • Influenza vaccination reduced complications during diabetes admission.
      • Vaccinated patients consumed less medical resources during the diabetes admission.

      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

      Abbreviations:

      ICD-9-CM (International Classification of Diseases 9th Revision Clinical Modification), CI (confidence interval), IV (influenza vaccination), OR (odds ratio)
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