After adjusting for bias in meta-analysis seasonal influenza vaccine remains effective in community-dwelling elderly

Darvishian, Maryam; Gefenaitė, Giedrė; Turner, Rebecca; Pechlivanoglou, Petros; Hoek, Wim van der; Heuvel, Edwin R. van den

doi:10.1016/j.jclinepi.2014.02.009

Cited by 39 publications

(27 citation statements)

References 33 publications

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“…Ortiz and collaborators [32] Hospital 12 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) Limitation of therapy in-hospital, n (%) DNR 72 (11.9) WH/WD 57 (9.4) about 28,000 adults are hospitalized for influenza-associated critical illness in the USA annually. A recent biasadjusted meta-analysis [33] confirmed that influenza vaccine was effective in preventing hospitalization from influenza and/or pneumonia and all-cause mortality in community-dwelling elderly. However, the evidence to support risk factors for influenza-related complications is still low and adequately powered studies are needed to address this issue [34,35].…”

Section: Discussionmentioning

confidence: 99%

The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

Sakr¹,

Ferrer

Reinhart³

et al. 2016

Intensive Care Med

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Purpose: In this prospective, multicenter, 14-day inception cohort study, we investigated the epidemiology, patterns of infections, and outcome in patients admitted to the intensive care unit (ICU) as a result of severe acute respiratory infections (SARIs). Methods:All patients admitted to one of 206 participating ICUs during two study weeks, one in November 2013 and the other in January 2014, were screened. SARI was defined as possible, probable, or microbiologically confirmed respiratory tract infection with recent onset dyspnea and/or fever. The primary outcome parameter was in-hospital mortality within 60 days of admission to the ICU. Results:Among the 5550 patients admitted during the study periods, 663 (11.9 %) had SARI. On admission to the ICU, Gram-positive and Gram-negative bacteria were found in 29.6 and 26.2 % of SARI patients but rarely atypical bacteria (1.0 %); viruses were present in 7.7 % of patients. Organ failure occurred in 74.7 % of patients in the ICU, mostly respiratory (53.8 %), cardiovascular (44.5 %), and renal (44.6 %). ICU and in-hospital mortality rates in patients with SARI were 20.2 and 27.2 %, respectively. In multivariable analysis, older age, greater severity scores at ICU admission, and hematologic malignancy or liver disease were independently associated with an increased risk of in-hospital death, whereas influenza vaccination prior to ICU admission and adequate antibiotic administration on ICU admission were associated with a lower risk.*Correspondence: yasser.sakr@med.uni-jena.de 1 Department of Anesthesiology and Intensive Care, Uniklinikum Jena, Erlanger Allee 103, 07743 Jena, Germany Full list of author information is available at the end of the article Take-home message: Admission to the ICU for SARI is common and associated with high morbidity and mortality rates. We identified several risk factors for in-hospital death that may be useful for risk stratification in these patients.On behalf of the IC-GLOSSARI Investigators and the Trials Group of the European Society of Intensive Care (ESICM), Rue Belliard, 19, 1040 Brussels, Belgium. Email: research@esicm.org.A complete list of IC-GLOSSARI investigators is provided in the "Appendix". Conclusions:Admission to the ICU for SARI is common and associated with high morbidity and mortality rates. We identified several risk factors for in-hospital death that may be useful for risk stratification in these patients.

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Section: Discussionmentioning

confidence: 99%

The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

Sakr¹,

Ferrer

Reinhart³

et al. 2016

Intensive Care Med

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“…Our review suggests that the 43–58% protection by the vaccine against laboratory‐confirmed influenza in the elderly was slightly lower in the tropics and subtropics compared to 50–77% protection seen in Europe, United States and other developed countries 61, 62. The protection in children (range 20–77%) and in healthy adults (range 50–59%) seen in the tropics and subtropics was comparable with that seen in developed countries 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74.…”

Section: Discussionmentioning

confidence: 92%

Seasonal influenza vaccine policy, use and effectiveness in the tropics and subtropics – a systematic literature review

Hirve

Lambach

Paget

et al. 2016

Influenza Resp Viruses

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AimThe evidence needed for tropical countries to take informed decisions on influenza vaccination is scarce. This article reviews policy, availability, use and effectiveness of seasonal influenza vaccine in tropical and subtropical countries.MethodGlobal health databases were searched in three thematic areas – policy, availability and protective benefits in the context of human seasonal influenza vaccine in the tropics and subtropics. We excluded studies on monovalent pandemic influenza vaccine, vaccine safety, immunogenicity and uptake, and disease burden.ResultsSeventy‐four countries in the tropics and subtropics representing 60% of the world's population did not have a national vaccination policy against seasonal influenza. Thirty‐eight countries used the Northern Hemisphere and 21 countries the Southern Hemisphere formulation. Forty‐six countries targeted children and 57 targeted the elderly; though, the age cut‐offs varied. Influenza vaccine supply increased twofold in recent years. However, coverage remained lower than five per 1000 population. Vaccine protection against laboratory‐confirmed influenza in the tropics ranged from 0% to 42% in the elderly, 20–77% in children and 50–59% in healthy adults. Vaccinating pregnant women against seasonal influenza prevented laboratory‐confirmed influenza in both mothers (50%) and their infants <6 months (49–63%).ConclusionGuidelines on vaccine composition, priority risk groups and vaccine availability varied widely. The evidence on vaccine protection was scarce. Countries in the tropics and subtropics need to strengthen and expand their evidence‐base required for making informed decisions on influenza vaccine introduction and expansion, and how much benefit to expect.

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“…The incidence of pneumococcal pneumonia has been shown to increase following influenza virus infection in the elderly [63]. Although the effectiveness, in relation to hospitalization and mortality rates, of the influenza vaccine alone in elderly patients has not been assessed by meta-analysis in the previous studies [64,65], a combined vaccination of the influenza vaccine and PPV is thought to be effective in these patients [66]. Inoculation with both these vaccines may have an additive effect in reducing pneumonia hospitalization in elderly patients with a risk of ASP [67].…”

Section: Pharmacologic Approaches For Dysphagia and Upper Airway Manamentioning

confidence: 99%

Update on the pathogenesis and management of pneumonia in the elderly-roles of aspiration pneumonia

Teramoto

Yoshida

Hizawa

2015

Respiratory Investigation

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After adjusting for bias in meta-analysis seasonal influenza vaccine remains effective in community-dwelling elderly

Cited by 39 publications

References 33 publications

The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

The Intensive Care Global Study on Severe Acute Respiratory Infection (IC-GLOSSARI): a multicenter, multinational, 14-day inception cohort study

Seasonal influenza vaccine policy, use and effectiveness in the tropics and subtropics – a systematic literature review

Update on the pathogenesis and management of pneumonia in the elderly-roles of aspiration pneumonia

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