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J Asthma. 2017 Jun 21:1-11. doi: 10.1080/02770903.2017.1332204. [Epub ahead of print]
Asthma and influenza vaccination in elderly hospitalized patients: Matched case-control study in Spain.
Su?rez-Varela MM1,2,3, Llopis A1,2,3, Fernandez-Fabrellas E4, Sanz F4, Perez-Lozano MJ5, Martin V6, Astray J7, Castilla J8, Egurrola M9, Force L10, Toledo D2,11, Dom?nguez ?2,11; Working group of project pi12/02079 ?effectiveness of influenza and pneumococcal polysaccharide 23-valent vaccines in people aged 65 years and more?.
Author information
Abstract
OBJECTIVES:
Influenza infection is an exacerbating factor for asthma, and its prevention is critical in managing asthmatic patients. We investigated the effect of influenza vaccination on asthmatic and non-asthmatic patients hospitalized with laboratory-confirmed influenza in Spain.
METHODS:
We made a matched case-control study to assess the frequency of hospitalization for influenza in people aged ≥65 years. Hospitalized patients with unplanned hospital admissions were recruited from 20 hospitals representing seven Spanish regions. Cases were defined as those hospitalized due to a laboratory-confirmed influenza infection and controls were matched by age, sex, and hospital. Data were obtained from clinical records, and patients stratified by clinical asthma history. Vaccination status and asthma due to influenza infection were analyzed according to sociodemographic variables and medical risk conditions. Multivariable analysis was made using conditional logistic regression models.
RESULTS:
582 hospitalized patients with influenza (15.8% asthmatic) and 1,570 hospitalized patients without influenza (7.9% asthmatic) were included. In the multivariable conditional logistic regression using unvaccinated and non-asthmatic patients as the reference group, vaccination significantly prevented influenza in non-asthmatic patients (aOR = 0.63; 95% CI: 0.45, 0.88) and also showed a trend for a possibly protective effect in asthmatic patients (aOR = 0.79; 95% CI: 0.34, 1.81).
CONCLUSION:
Our results suggest that influenza vaccination could be a protective factor for asthmatic patients, although the results are inconclusive and further research is required. Practically, given the better clinical evolution of vaccinated asthma cases, and the lack of better evidence, the emphasis on vaccination of this group should continue.
KEYWORDS:
Asthma; asthma management; elderly; influenza; influenza-related hospitalization; laboratory-confirmed influenza; multivariable conditional logistic regression; prevention; protective factor; vaccination
PMID: 28636411 DOI: 10.1080/02770903.2017.1332204
Asthma and influenza vaccination in elderly hospitalized patients: Matched case-control study in Spain.
Su?rez-Varela MM1,2,3, Llopis A1,2,3, Fernandez-Fabrellas E4, Sanz F4, Perez-Lozano MJ5, Martin V6, Astray J7, Castilla J8, Egurrola M9, Force L10, Toledo D2,11, Dom?nguez ?2,11; Working group of project pi12/02079 ?effectiveness of influenza and pneumococcal polysaccharide 23-valent vaccines in people aged 65 years and more?.
Author information
Abstract
OBJECTIVES:
Influenza infection is an exacerbating factor for asthma, and its prevention is critical in managing asthmatic patients. We investigated the effect of influenza vaccination on asthmatic and non-asthmatic patients hospitalized with laboratory-confirmed influenza in Spain.
METHODS:
We made a matched case-control study to assess the frequency of hospitalization for influenza in people aged ≥65 years. Hospitalized patients with unplanned hospital admissions were recruited from 20 hospitals representing seven Spanish regions. Cases were defined as those hospitalized due to a laboratory-confirmed influenza infection and controls were matched by age, sex, and hospital. Data were obtained from clinical records, and patients stratified by clinical asthma history. Vaccination status and asthma due to influenza infection were analyzed according to sociodemographic variables and medical risk conditions. Multivariable analysis was made using conditional logistic regression models.
RESULTS:
582 hospitalized patients with influenza (15.8% asthmatic) and 1,570 hospitalized patients without influenza (7.9% asthmatic) were included. In the multivariable conditional logistic regression using unvaccinated and non-asthmatic patients as the reference group, vaccination significantly prevented influenza in non-asthmatic patients (aOR = 0.63; 95% CI: 0.45, 0.88) and also showed a trend for a possibly protective effect in asthmatic patients (aOR = 0.79; 95% CI: 0.34, 1.81).
CONCLUSION:
Our results suggest that influenza vaccination could be a protective factor for asthmatic patients, although the results are inconclusive and further research is required. Practically, given the better clinical evolution of vaccinated asthma cases, and the lack of better evidence, the emphasis on vaccination of this group should continue.
KEYWORDS:
Asthma; asthma management; elderly; influenza; influenza-related hospitalization; laboratory-confirmed influenza; multivariable conditional logistic regression; prevention; protective factor; vaccination
PMID: 28636411 DOI: 10.1080/02770903.2017.1332204