ارتباط بین دریافت واکسن آنفلوانزا با بستری شدن در بیمارستان و میرایی کلی در سالمندان: مطالعه‌ی مروری نظام‌مند و متاآنالیز

نوع مقاله : مقاله مروری

نویسندگان

1 دانشجوی کارشناسی ارشد اپیدمیولوژی، کمیته‌ی تحقیقات دانشجویی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران

2 استاد، گروه اپیدمیولوژی و آمار زیستی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران

3 استادیار، مرکز تحقیقات مدل‌سازی در سلامت، دانشگاه علوم پزشکی شهرکرد، شهرکرد، ایران

چکیده

مقدمه: طی سالیان اخیر، مطالعات مختلفی در زمینه‌ی بررسی نقش واکسن آنفلوانزا در کاهش خطر بستری و مرگ ‌و میر ناشی از بیماری‌های مختلف در سالمندان انجام ‌شده است، با این وجود نتایج آن‌ها تناقضات آشکاری را نشان می‌دهد. هدف از انجام پژوهش حاضر، بررسی ارتباط بین دریافت واکسن آنفلوانزا با خطر بستری در بیمارستان و مرگ ‌و میر کلی در سالمندان بود.روش‌ها: این مطالعه به ‌صورت مرور نظام‌مند و متاآنالیز بر روی تحقیقات کارآزمایی بالینی که در بازه‌ی زمانی سال‌های 1980 تا 2020 در پایگاه‌های اطلاعاتی Scopus، Web of Science، Embase، Google Scholar، ScienceDirect، Cochrane و PubMed منتشر شده بود، انجام‌ گردید. داده‌ها در نرم‌افزار Stata مورد تجزیه‌ و تحلیل‌ها قرار گرفت. 05/0 > P به عنوان سطح معنی‌داری در نظر گرفته شود.یافته‌ها: در جستجوی اولیه، 283 مقاله استخراج گردید که با در نظر گرفتن معیارهای تحقیق، در نهایت 9 مطالعه‌ی کارآزمایی بالینی وارد متاآنالیز شد. بر اساس نتایج، نسبت شانس بستری در بیمارستان برای سالمندان به ‌طورکلی، 001/0 > P، 82/0- 51/0 = Confidence interval (CI) 95 درصد، 65/0 = (OR) Odds ration و نسبت شانس مرگ ‌و میر کلی، 001/0 > P، 97/0- 92/0 = CI 95 درصد، 95/0 = OR بود. در بررسی ارتباط بین دریافت واکسن آنفلوانزا و بستری شدن و مرگ ‌و میر سالمندان، تورش انتشار مشاهده نشد.نتیجه‌گیری: دریافت واکسن آنفلوانزا می‌تواند منجر به کاهش 35 ‌درصدی خطر بستری در بیمارستان و کاهش 5 ‌درصدی خطر مرگ‌ و میر کلی در سالمندان شود. بنابراین، ممکن است دریافت این واکسن به ‌عنوان یک مداخله‌ی پیش‌گیرانه از مرگ ‌و میر سالمندان و بستری شدن آن‌ها در بیمارستان، کمک امیدوارکننده‌ای باشد.

کلیدواژه‌ها

عنوان مقاله [English]

The Relationship between Influenza Vaccine and Hospitalization and Mortality in the Elderly: A Systematic Review and Meta-Analysis

نویسندگان [English]

  • Nilay Rezaei 1
  • Soleiman Kheiri 2
  • Masoumeh Mousavi 3
  • Abdollah Mohammadian-Hafshejani 3
1 MSc Student of Epidemiology, Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
2 Professor, Department of Epidemiology and Biostatistics, School of Public Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
3 Assistant Professor, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
چکیده [English]

Background: In recent years, various studies have been conducted to investigate the role of influenza vaccine in reducing the risk of hospitalization and death in the elderly. However, the results of these studies are clearly contradictory. Accordingly, the present study aimed to investigate the relationship between receiving the flu vaccine with the risk of hospitalization and mortality in the elderly.Methods: This study was a systematic review and meta-analysis of clinical trial studies published in databases (Web of science, Scopus, PubMed, Cochrane, Science Direct, Google Scholar, and Embase) between the years 1980 and 2020. All analyzes were performed by Stata14 statistical software, and the significance level in this study was considered as 0.05.Findings: In the initial search, 283 articles were retrieved of which, considering the study criteria, finally 9 clinical trial studies were included in the meta-analysis. Based on the results of meta-analysis, the overall odds ratio (OR) of hospitalization for the elderly was equal to 0.65 (95% CI: 0.82 - 0.51; P <0.001); and the overall OR of death was equal to 0.95 (95% CI: 0.92 - 0.97; P <0.001). There was no publication bias in the study of the relationship between receiving the flu vaccine and hospitalization and mortality of the elderly.Conclusion: Getting the flu vaccine in the elderly can reduce the risk of hospitalization by 35% and the risk of overall death by 5%. Therefore, it may be promising to receive this vaccine as a preventive intervention for elderly deaths and hospitalizations.

کلیدواژه‌ها [English]

  • Influenza vaccine
  • Hospitalization
  • Mortality
  • Elderly
  • Systematic Review
  • Meta-Analysis

مراجع

  1. Krammer F, Smith GJD, Fouchier RAM, Peiris M, Kedzierska K, Doherty PC, et al. Influenza. Nat Rev Dis Primers 2018; 4(1): 3.
  2. Kiani MA, Ghazanfarpour M, Saeidi M. Influenza: A unique disease. Int J Pediatr. 2019; 7(4): 9349-54.
  3. Lee KR, Bae JH, Hwang IC, Kim KK, Suh HS, Ko KD. Effect of influenza vaccination on risk of stroke: A systematic review and meta-analysis. Neuroepidemiology 2017; 48(3-4): 103-10.
  4. Pakzad R, Mohammadian-Hafshejani A, Khosravi B, Soltani S, Pakzad I, Mohammadian M, et al. The incidence and mortality of esophageal cancer and their relationship to development in Asia. Ann Transl Med 2016; 4(2): 29.
  5. Hazra NC, Rudisill C, Gulliford MC. Determinants of health care costs in the senior elderly: Age, comorbidity, impairment, or proximity to death? Eur J Health Econ 2018; 19(6): 831-42.
  6. Almasi Z, Mohammadian-Hafshejani A, Salehiniya H. Incidence, mortality, and epidemiological aspects of cancers in Iran; differences with the world data. J BUON 2016; 21(4): 994-1004.
  7. Razi S, Enayatrad M, Mohammadian-Hafshejani A, Salehiniya H, Fathali-Loy-Dizaji M, Soltani S. The epidemiology of skin cancer and its trend in iran. Int J Prev Med 2015; 6: 64.
  8. Arabsalmani M, Mohammadian-Hafshejani A, Ghoncheh M, Hadadian F, Towhidi F, Vafaee K, et al. Incidence and mortality of kidney cancers, and human development index in Asia; a matter of concern. J Nephropathol 2017; 6(1): 30-42.
  9. Rasel M, Ardalan A. The future of ageing and its health care costs: A warning for health system. Salmand Iran J Ageing 2007; 2(2): 300-5.
  10. Chen CM, Chen HJ, Chen WS, Lin CC, Hsu CC, Hsu YH. Clinical effectiveness of influenza vaccination in patients with rheumatoid arthritis. Int J Rheum Dis 2018; 21(6): 1246-53.
  11. Mulpuru S, Li L, Ye L, Hatchette T, Andrew MK, Ambrose A, et al. Effectiveness of influenza vaccination on hospitalizations and risk factors for severe outcomes in hospitalized patients with COPD. Chest 2019; 155(1): 69-78.
  12. Wang IK, Lin CL, Lin PC, Chang SN, Chou CY, Yen TH, et al. Seasonal influenza vaccination is associated with reduced morbidity and mortality in peritoneal dialysis patients. Nephrol Dial Transplant 2016; 31(2): 269-74.
  13. Anderson ML, Dobkin C, Gorry D. The effect of influenza vaccination for the elderly on hospitalization and mortality: an observational study with a regression discontinuity design. Ann Intern Med 2020; 172(7): 445-52.
  14. Gilca R, Skowronski DM, Douville-Fradet M, Amini R, Boulianne N, Rouleau I, et al. Mid-season estimates of influenza vaccine effectiveness against influenza a(h3n2) hospitalization in the elderly in Quebec, Canada, January 2015. PLoS One 2015; 10(7): e0132195.
  15. Kaselitz TB, Martin ET, Power LE, Cinti S. Infectious Diseases in Clinical Practice 2019; 27(6): 328-33.
  16. Yokomichi H, Kurihara S, Yokoyama T, Inoue E, Tanaka-Taya K, Kono S, et al. The pandemic influenza A (H1N1) 2009 vaccine does not increase the mortality rate of idiopathic interstitial pneumonia: a matched case-control study. PLoS One 2014; 9(2): e88927.
  17. Song JY, Noh JY, Lee JS, Wie SH, Kim YK, Lee J, et al. Effectiveness of influenza and pneumococcal polysaccharide vaccines against influenza-related outcomes including pneumonia and acute exacerbation of cardiopulmonary diseases: Analysis by dominant viral subtype and vaccine matching. PLoS One 2018; 13(12): e0207918.
  18. Zhang D, Zhang Y, Wang Q, Lock J, Pan Y, Cui S, et al. The effectiveness of influenza vaccination in preventing hospitalizations in elderly in Beijing, 2016-18. Vaccine 2019; 37(13): 1853-8.
  19. Pebody RG, Zhao H, Whitaker HJ, Ellis J, Donati M, Zambon M, et al. Effectiveness of influenza vaccine in children in preventing influenza associated hospitalisation, 2018/19, England. Vaccine 2020; 38(2): 158-64.
  20. Hendarto A, Yosia M, Sastroasmoro S. Quality analysis of randomized controlled trials reporting in the field of pediatrics by Indonesian researchers. J Evid Based Med 2019; 12(2): 105-12.
  21. Kim SY, Kim KN, Kim DW, Kang MS. Reporting quality analysis of randomized controlled trials in journal of neurosurgical anesthesiology: A methodological assessment. J Neurosurg Anesthesiol 2021; 33(2): 154-60.
  22. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, et al. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials 1996; 17(1): 1-12.
  23. Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D, et al. The revised CONSORT statement for reporting randomized trials: Explanation and elaboration. Ann Intern Med 2001; 134(8): 663-94.
  24. De Villiers PJ, Steele AD, Hiemstra LA, Rappaport R, Dunning AJ, Gruber WC, et al. Efficacy and safety of a live attenuated influenza vaccine in adults 60 years of age and older. Vaccine 2009; 28(1): 228-34.
  25. Govaert TM, Thijs CT, Masurel N, Sprenger MJ, Dinant GJ, Knottnerus JA. The efficacy of influenza vaccination in elderly individuals. A randomized double-blind placebo-controlled trial. JAMA 1994; 272(21): 1661-5.
  26. Ciszewski A, Bilinska ZT, Brydak LB, Kepka C, Kruk M, Romanowska M, et al. Influenza vaccination in secondary prevention from coronary ischaemic vents in coronary artery disease: FLUCAD study. Eur Heart J 2008; 29(11): 1350-8.
  27. Phrommintikul A, Kuanprasert S, Wongcharoen W, Kanjanavanit R, Chaiwarith R, Sukonthasarn A. Influenza vaccination reduces cardiovascular events in patients with acute coronary syndrome. Eur Heart J 2011; 32(14): 1730-5.
  28. Verhees RAF, Thijs C, Ambergen T, Dinant GJ, Knottnerus JA. Influenza vaccination in the elderly: 25 years follow-up of a randomized controlled trial. No impact on long-term mortality. PLoS One 2019; 14(5): e0216983.
  29. Armstrong BG, Mangtani P, Fletcher A, Kovats S, McMichael A, Pattenden S, et al. Effect of influenza vaccination on excess deaths occurring during periods of high circulation of influenza: cohort study in elderly people. BMJ 2004; 329(7467): 660.
  30. Fireman B, Lee J, Lewis N, Bembom O, van der Laan M, Baxter R. Influenza vaccination and mortality: Differentiating vaccine effects from bias. Am J Epidemiol 2009; 170(5): 650-6.
  31. Liu IF, Huang CC, Chan WL, Huang PH, Chung CM, Lin SJ, et al. Effects of annual influenza vaccination on mortality and hospitalization in elderly patients with ischemic heart disease: A nationwide population-based study. Prev Med 2012; 54(6): 431-3.
  32. Wang IK, Lin CL, Chang YC, Lin PC, Liang CC, Liu YL, et al. Effectiveness of influenza vaccination in elderly diabetic patients: A retrospective cohort study. Vaccine 2013; 31(4): 718-24.
  33. Puig-Barbera J, Diez-Domingo J, Varea AB, Chavarri GS, Rodrigo JA, Hoyos SP, et al. Effectiveness of MF59-adjuvanted subunit influenza vaccine in preventing hospitalisations for cardiovascular disease, cerebrovascular disease and pneumonia in the elderly. Vaccine 2007; 25(42): 7313-21.
  34. Ortqvist A, Granath F, Askling J, Hedlund J. Influenza vaccination and mortality: prospective cohort study of the elderly in a large geographical area. Eur Respir J 2007; 30(3): 414-22.
  35. Nichol KL, Nordin J, Mullooly J, Lask R, Fillbrandt K, Iwane M. Influenza vaccination and reduction in hospitalizations for cardiac disease and stroke among the elderly. N Engl J Med 2003; 348(14): 1322-32.
  36. Oura A, Ohnishi H, Hara M, Sakauchi F, Fushiki Y, Mori M. Effectiveness of Influenza vaccines in reducing risk of acute febrile illness among community-dwelling elderly, 2006-07 seasons: Population-based cohort study in Japan. Sapporo Med J 2009; 78: 31-7.
  37. Hung IF, Leung AY, Chu DW, Leung D, Cheung T, Chan CK, et al. Prevention of acute myocardial infarction and stroke among elderly persons by dual pneumococcal and influenza vaccination: A prospective cohort study. Clin Infect Dis 2010; 51(9): 1007-16.
مجله دانشکده پزشکی اصفهان
دوره 39، شماره 652 - شماره پیاپی 652
بهمن و اسفند 1400
صفحه 934-943

فایل ها

سابقه مقاله

  • تاریخ دریافت: 08 شهریور 1400
  • تاریخ بازنگری: 01 اردیبهشت 1403
  • تاریخ پذیرش: 17 فروردین 1401

هم رسانی

ارجاع به این مقاله

آمار