Wan-Chi Liu1,2, Chao-Shun Lin2,3,4, Chun-Chieh Yeh5,6, Hsin-Yun Wu1,2, Yuarn-Jang Lee7, Chi-Li Chung8,9, Yih-Giun Cherng1,2, Ta-Liang Chen2,3,4, Chien-Chang Liao1,2,3,4,10. 1. Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, Taiwan. 2. Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taiwan. 3. Department of Anesthesiology, Taipei Medical University Hospital, Taiwan. 4. Anesthesiology and Health Policy Research Center, Taipei Medical University Hospital, Taiwan. 5. Department of Surgery, China Medical University Hospital, Taichung, Taiwan. 6. Department of Surgery, University of Illinois, Chicago. 7. Divisions of Infectious Diseases, Taipei Medical University Hospital, Taiwan. 8. Divisions of Pulmonary Medicine, Taipei Medical University Hospital, Taiwan. 9. Department of Internal Medicine, Taipei Medical University Hospital, Taiwan. 10. School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
Abstract
Background: Limited information is available on the association between influenza vaccination and postoperative outcomes. Methods: Using Taiwan's National Health Insurance Research Database reimbursement claims data from 2008-2013, we conducted a matched cohort study of 16903 patients aged >66 years who received influenza vaccinations and later underwent major surgery. Using a propensity score matching procedure adjusted for sociodemographic characteristics, medical condition, surgery type, and anesthesia type, 16903 controls who underwent surgery but were not vaccinated were selected. Logistic regressions were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for postoperative pneumonia and in-hospital mortality associated with influenza vaccination. Results: Patients who received preoperative influenza vaccination had a lower risk of postoperative pneumonia (OR, 0.60; 95% CI, .56-.64) and in-hospital mortality (OR, 0.46; 95% CI, .39-.56), compared with unvaccinated patients, in both sexes and every age group. Vaccinated patients who underwent surgery also had a decreased risk of postoperative intensive care unit admission (OR, 0.56; 95% CI, .53-.60), shorter hospital stays (P < .0001), and lower medical expenditures (P < .0001) than nonvaccinated controls. Conclusions: Vaccinated geriatric patients who underwent surgery had lower risks of pneumonia and in-hospital mortality, compared with unvaccinated patients who underwent similar major surgeries. Further studies are needed to explain how preoperative influenza vaccination improves perioperative outcomes.
Background: Limited information is available on the association between influenza vaccination and postoperative outcomes. Methods: Using Taiwan's National Health Insurance Research Database reimbursement claims data from 2008-2013, we conducted a matched cohort study of 16903 patients aged >66 years who received influenza vaccinations and later underwent major surgery. Using a propensity score matching procedure adjusted for sociodemographic characteristics, medical condition, surgery type, and anesthesia type, 16903 controls who underwent surgery but were not vaccinated were selected. Logistic regressions were used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for postoperative pneumonia and in-hospital mortality associated with influenza vaccination. Results:Patients who received preoperative influenza vaccination had a lower risk of postoperative pneumonia (OR, 0.60; 95% CI, .56-.64) and in-hospital mortality (OR, 0.46; 95% CI, .39-.56), compared with unvaccinated patients, in both sexes and every age group. Vaccinated patients who underwent surgery also had a decreased risk of postoperative intensive care unit admission (OR, 0.56; 95% CI, .53-.60), shorter hospital stays (P < .0001), and lower medical expenditures (P < .0001) than nonvaccinated controls. Conclusions: Vaccinated geriatric patients who underwent surgery had lower risks of pneumonia and in-hospital mortality, compared with unvaccinated patients who underwent similar major surgeries. Further studies are needed to explain how preoperative influenza vaccination improves perioperative outcomes.