Flu shots benefit patients hospitalized with pneumonia

Routine, in-hospital influenza vaccinations for all adults hospitalized with pneumonia may save lives and reduce hospitalizations, according to a study presented at CHEST 2019, the annual meeting of the American College of Chest Physicians, held from Oct. 19 to 23 in New Orleans.

Kam Sing Ho, M.D., from Mount Sinai St. Luke's and Mount Sinai West in New York City, and colleagues used data from the Nationwide Readmission Database for 2014 to identify adults with a principal diagnosis of community-acquired pneumonia (CAP) and documentation of in-hospital influenza vaccination. Rates of 30-day readmission were evaluated.

The researchers identified 825,906 hospital patients with a primary diagnosis of CAP, of whom 1.91 percent (14,047 patients) received influenza vaccination. After propensity score matching for demographic and clinical characteristics, 9,777 CAP patients with and without influenza vaccinations were paired. Overall, the 30-day rate of readmission was 11.9 percent, with pneumonia being the most common reason for readmission (98.1 percent). In-hospital influenza vaccinations independently predicted a lower risk for readmission (hazard ratio, 0.821). Lower risk for readmission was also associated with private insurance and high-income status. Higher risk for readmission was associated with not having influenza vaccinations (hazard ratio, 1.217), advanced age, Medicare insurance, higher Charlson comorbidity score, atrial fibrillation, acute respiratory failure, and in-hospital oxygen. Readmitted patients had a significantly higher mortality versus those with just the index admission.

"The question is how to best develop practices that would ensure successful vaccination in the inpatient setting, specifically for patients admitted for community-acquired pneumonia," Michelle Cao, M.D., member of the American College of Chest Physicians Scientific Presentations and Awards Committee, said in a statement.

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