Risk of healthcare visits from influenza in subjects with diabetes and impacts of early vaccination.

IF 3.7 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM BMJ Open Diabetes Research & Care Pub Date : 2024-08-06 DOI:10.1136/bmjdrc-2023-003841
Ronald Horswell, San Chu, Addison E Stone, Daniel Fort, Gabriel Uwaifo, Vivian A Fonseca, Elizabeth B Norton
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Abstract

Introduction: The objective of this study was to determine the burden of influenza disease in patients with or without diabetes in a population of American adults to understand the benefits of seasonal vaccination.

Research design and methods: We performed a retrospective cohort study using electronic medical records totaling 1,117,263 from two Louisiana healthcare providers spanning January 2012 through December 2017. Adults 18 years or older with two or more records within the study period were included. The primary outcome quantified was influenza-related diagnosis during inpatient (IP) or emergency room (ER) visits and risk reduction with the timing of immunization.

Results: Influenza-related IP or ER visits totaled 0.0122-0.0169 events per person within the 2013-2016 influenza seasons. Subjects with diabetes had a 5.6-fold more frequent influenza diagnosis for IP or ER visits than in subjects without diabetes or 3.7-fold more frequent when adjusted for demographics. Early immunization reduced the risk of influenza healthcare utilization by 66% for subjects with diabetes or 67% for subjects without diabetes when compared with later vaccination for the 2013-2016 influenza seasons. Older age and female sex were associated with a higher incidence of influenza, but not a significant change in risk reduction from vaccination.

Conclusions: The risk for influenza-related healthcare utilization was 3.7-fold higher if patients had diabetes during 2013-2016 influenza seasons. Early immunization provides a significant benefit to adults irrespective of a diabetes diagnosis. All adults, but particularly patients with diabetes, should be encouraged to get the influenza vaccine at the start of the influenza season.

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糖尿病患者因流感就医的风险及早期接种疫苗的影响。
导言:本研究旨在确定美国成年人群中有无糖尿病患者的流感疾病负担,以了解接种季节性疫苗的益处:我们利用路易斯安那州两家医疗机构 2012 年 1 月至 2017 年 12 月期间共计 1,117,263 份电子病历进行了一项回顾性队列研究。研究对象包括在研究期间有两次或两次以上记录的 18 岁或 18 岁以上的成年人。量化的主要结果是住院(IP)或急诊室(ER)就诊期间与流感相关的诊断,以及免疫接种时机的风险降低情况:2013-2016年流感季节期间,与流感相关的住院或急诊就诊总计为0.0122-0.0169次/人。与无糖尿病的受试者相比,糖尿病受试者的流感诊断IP或急诊就诊频率高出5.6倍,经人口统计学调整后,则高出3.7倍。与2013-2016年流感季节较晚接种疫苗的情况相比,早期接种疫苗可将糖尿病患者使用流感医疗服务的风险降低66%,将非糖尿病患者使用流感医疗服务的风险降低67%。高龄和女性性别与较高的流感发病率有关,但接种疫苗后降低的风险没有显著变化:结论:在2013-2016年流感季节,如果患者患有糖尿病,则其使用流感相关医疗服务的风险要高出3.7倍。无论诊断出糖尿病与否,早期免疫接种都能为成年人带来显著益处。应鼓励所有成年人,尤其是糖尿病患者,在流感季节开始时接种流感疫苗。
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来源期刊
BMJ Open Diabetes Research & Care
BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
9.30
自引率
2.40%
发文量
123
审稿时长
18 weeks
期刊介绍: BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.
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