PDF(Pubmed)
Abstract：
BACKGROUND: 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.
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.
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.
摘要：
背景：这项研究的目的是确定美国成年人中有或没有糖尿病的患者的流感疾病负担，以了解季节性疫苗接种的益处。
方法：我们进行了一项回顾性队列研究，使用了2012年1月至2017年12月来自两个路易斯安那州医疗保健提供者的1,117,263份电子病历。包括在研究期内有两个或更多记录的18岁或以上的成年人。量化的主要结果是住院患者（IP）或急诊室（ER）就诊期间的流感相关诊断以及随着免疫接种时间的降低风险。
结果：在2013-2016年流感季节内，与流感相关的IP或ER就诊总数为每人0.0122-0.0169次。患有糖尿病的受试者对IP或ER就诊的流感诊断频率比没有糖尿病的受试者高5.6倍，或者根据人口统计学进行调整时的流感诊断频率高3.7倍。与2013-2016年流感季节的后期疫苗接种相比，早期免疫将糖尿病受试者的流感医疗保健利用风险降低了66%，非糖尿病受试者的流感医疗保健利用风险降低了67%。年龄和女性与流感发病率较高有关，但接种疫苗的风险降低并没有显著变化。
结论：如果患者在2013-2016年流感季节患有糖尿病，则流感相关医疗保健利用的风险高出3.7倍。早期免疫为成年人提供了显著的益处,而与糖尿病诊断无关。所有成年人,但特别是糖尿病患者，应该鼓励在流感季节开始时接种流感疫苗。
方法：我们进行了一项回顾性队列研究，使用了2012年1月至2017年12月来自两个路易斯安那州医疗保健提供者的1,117,263份电子病历。包括在研究期内有两个或更多记录的18岁或以上的成年人。量化的主要结果是住院患者（IP）或急诊室（ER）就诊期间的流感相关诊断以及随着免疫接种时间的降低风险。
结果：在2013-2016年流感季节内，与流感相关的IP或ER就诊总数为每人0.0122-0.0169次。患有糖尿病的受试者对IP或ER就诊的流感诊断频率比没有糖尿病的受试者高5.6倍，或者根据人口统计学进行调整时的流感诊断频率高3.7倍。与2013-2016年流感季节的后期疫苗接种相比，早期免疫将糖尿病受试者的流感医疗保健利用风险降低了66%，非糖尿病受试者的流感医疗保健利用风险降低了67%。年龄和女性与流感发病率较高有关，但接种疫苗的风险降低并没有显著变化。
结论：如果患者在2013-2016年流感季节患有糖尿病，则流感相关医疗保健利用的风险高出3.7倍。早期免疫为成年人提供了显著的益处,而与糖尿病诊断无关。所有成年人,但特别是糖尿病患者，应该鼓励在流感季节开始时接种流感疫苗。
