71f7e95709c2f6d87cb46c622d0041be 271487.pdf 6ab22a09242fae6ae8894c041789f8c725dcd135 271487.pdf a16a4ec9e83c4c4d70e94d1d3bde510edabec73f2904c5b1a6ea1923e75ea385 271487.pdf Title: Influenza Vaccine Effectiveness in Preventing Severe Outcomes in Patients Hospitalized with Laboratory-Confirmed Influenza during the 2017–2018 Season. A Retrospective Cohort Study in Catalonia (Spain) Subject: Seasonal influenza is a common cause of hospital admission, especially in older people and those with comorbidities. The objective of this study was to determine influenza vaccine effectiveness (VE) in preventing intensive care admissions and shortening the length of stay (LOS) in hospitalized laboratory-confirmed influenza cases (HLCI) in Catalonia (Spain). A retrospective cohort study was carried out during the 2017–2018 season in HLCI aged 18 years from 14 public hospitals. Differences in means and proportions were assessed using a t-test or a chi-square test as necessary and the differences were quantified using standardized effect measures: Cohen’s d for quantitative and Cohen’s w for categorical variables. Adjusted influenza vaccine effectiveness in preventing severity was estimated by multivariate logistic regression where the adjusted VE = (1 - adjusted odds ratio) 100%; adjustment was also made using the propensity score. We analyzed 1414 HLCI aged 18 years; 465 (33%) were vaccinated, of whom 437 (94%) were aged 60 years, 269 (57.8%) were male and 295 (63.4%) were positive for influenza type B. ICU admission was required in 214 (15.1%) cases. There were 141/1118 (12.6%) ICU admissions in patients aged 60 years and 73/296 (24.7%) in those aged <60 years (p < 0.001). The mean LOS and ICU LOS did not differ significantly between vaccinated and unvaccinated patients. There were 52/465 (11.2%) ICU admissions in vaccinated cases vs. 162/949 (17.1%) in unvaccinated cases. Patients admitted to the ICU had a longer hospital LOS (mean: 22.4 [SD 20.3] days) than those who were not (mean: 11.1 [SD 14.4] days); p < 0.001. Overall, vaccination was associated with a lower risk of ICU admission. Taking virus types A and B together, the estimated adjusted VE in preventing ICU admission was 31% (95% CI 1–52; p = 0.04). When stratified by viral type, the aVE was 40% for type A (95% CI -11–68; p = 0.09) and 25% for type B (95% CI -18–52; p = 0.21). Annual influenza vaccination may prevent ICU admission in cases of HLCI. A non-significantly shorter mean hospital stay was observed in vaccinated cases. Our results support the need to increase vaccination uptake and public perception of the benefits of influenza vaccination in groups at a higher risk of hospitalization and severe outcomes. Keywords: influenza; intensive care unit; vaccine effectiveness; length of stay Author: Lesly Acosta, Nuria Soldevila, Nuria Torner, Ana Martínez, Xavier Ayneto, Cristina Rius, Mireia Jané, Angela Domínguez and the Influenza Surveillance Network of Catalonia, PIDIRAC Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Dec 17 09:51:53 2021 CET ModDate: Fri Dec 17 12:21:32 2021 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 2846036 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- IYDCBB+VnURWPalladioL Type 1 Custom yes yes no 10 0 IJSYIP+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 TJHATC+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 LFPAUA+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 TXHBWD+CMSY10 Type 1 Builtin yes yes no 28 0 YSPQJI+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 HOWKDX+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 40 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 62 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 66 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 70 0 QLBIEB+URWPalladioL-BoldItal Type 1 Custom yes yes no 99 0 RIJDHR+CMBSY10 Type 1 Builtin yes yes no 103 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-02-17 02:37:36 CET RepresentationInformation: 271487.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-02-16 15:28:21 CET Size: 2846036 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 249 FreeObjects: 3 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Info: Title: Influenza Vaccine Effectiveness in Preventing Severe Outcomes in Patients Hospitalized with Laboratory-Confirmed Influenza during the 2017 2018 Season. A Retrospective Cohort Study in Catalonia (Spain) Author: Lesly Acosta, Nuria Soldevila, Nuria Torner, Ana Martínez, Xavier Ayneto, Cristina Rius, Mireia Jané, Angela Domínguez and the Influenza Surveillance Network of Catalonia, PIDIRAC Subject: Seasonal influenza is a common cause of hospital admission, especially in older people and those with comorbidities. The objective of this study was to determine influenza vaccine effectiveness (VE) in preventing intensive care admissions and shortening the length of stay (LOS) in hospitalized laboratory-confirmed influenza cases (HLCI) in Catalonia (Spain). A retrospective cohort study was carried out during the 2017 2018 season in HLCI aged 18 years from 14 public hospitals. Differences in means and proportions were assessed using a t-test or a chi-square test as necessary and the differences were quantified using standardized effect measures: Cohen’s d for quantitative and Cohen’s w for categorical variables. Adjusted influenza vaccine effectiveness in preventing severity was estimated by multivariate logistic regression where the adjusted VE = (1 - adjusted odds ratio) 100%; adjustment was also made using the propensity score. We analyzed 1414 HLCI aged 18 years; 465 (33%) were vaccinated, of whom 437 (94%) were aged 60 years, 269 (57.8%) were male and 295 (63.4%) were positive for influenza type B. ICU admission was required in 214 (15.1%) cases. There were 141/1118 (12.6%) ICU admissions in patients aged 60 years and 73/296 (24.7%) in those aged <60 years (p < 0.001). The mean LOS and ICU LOS did not differ significantly between vaccinated and unvaccinated patients. There were 52/465 (11.2%) ICU admissions in vaccinated cases vs. 162/949 (17.1%) in unvaccinated cases. Patients admitted to the ICU had a longer hospital LOS (mean: 22.4 [SD 20.3] days) than those who were not (mean: 11.1 [SD 14.4] days); p < 0.001. Overall, vaccination was associated with a lower risk of ICU admission. Taking virus types A and B together, the estimated adjusted VE in preventing ICU admission was 31% (95% CI 1 52; p = 0.04). When stratified by viral type, the aVE was 40% for type A (95% CI -11 68; p = 0.09) and 25% for type B (95% CI -18 52; p = 0.21). Annual influenza vaccination may prevent ICU admission in cases of HLCI. A non-significantly shorter mean hospital stay was observed in vaccinated cases. Our results support the need to increase vaccination uptake and public perception of the benefits of influenza vaccination in groups at a higher risk of hospitalization and severe outcomes. Keywords: influenza; intensive care unit; vaccine effectiveness; length of stay Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Dec 17 09:51:53 CET 2021 ModDate: Fri Dec 17 12:21:32 CET 2021 ID: 0xd0841685630485982ba180b9355d90f6, 0xd0841685630485982ba180b9355d90f6 Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: YSPQJI+VnURWPalladioL-Bold FontSubset: true FirstChar: 178 LastChar: 189 FontDescriptor: FontName: YSPQJI+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: QLBIEB+URWPalladioL-BoldItal FontSubset: true FirstChar: 110 LastChar: 112 FontDescriptor: FontName: QLBIEB+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: TJHATC+URWPalladioL-Bold FontSubset: true FirstChar: 2 LastChar: 150 FontDescriptor: FontName: TJHATC+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: RIJDHR+CMBSY10 FontSubset: true FirstChar: 21 LastChar: 21 FontDescriptor: FontName: RIJDHR+CMBSY10 Flags: Symbolic FontBBox: -26, -940, 1332, 825 FontFile: true Font: BaseFont: LFPAUA+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: LFPAUA+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: IYDCBB+VnURWPalladioL FontSubset: true FirstChar: 129 LastChar: 243 FontDescriptor: FontName: IYDCBB+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: TXHBWD+CMSY10 FontSubset: true FirstChar: 0 LastChar: 21 FontDescriptor: FontName: TXHBWD+CMSY10 Flags: Symbolic FontBBox: -29, -960, 1116, 775 FontFile: true Font: BaseFont: IJSYIP+URWPalladioL-Ital FontSubset: true FirstChar: 3 LastChar: 122 FontDescriptor: FontName: IJSYIP+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 35, 759, 147, 795 Annotation: Subtype: Link Rect: 515, 759, 560, 795 Annotation: Subtype: Link Rect: 189, 622, 200, 635 Annotation: Subtype: Link Rect: 276, 622, 287, 635 Annotation: Subtype: Link Rect: 215, 609, 226, 623 Annotation: Subtype: Link Rect: 105, 358, 154, 367 Annotation: Subtype: Link Rect: 35, 346, 122, 355 Annotation: Subtype: Link Rect: 35, 162, 97, 184 Annotation: Subtype: Link Rect: 153, 89, 154, 98 Annotation: Subtype: Link Rect: 35, 77, 147, 86 Annotation: Subtype: Link Rect: 112, 17, 241, 28 Annotation: Subtype: Link Rect: 409, 17, 558, 28 Annotation: Subtype: Link Rect: 35, 506, 87, 525 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 515, 737, 522, 746 ActionDest: 122 Annotation: Subtype: Link Rect: 549, 712, 556, 721 ActionDest: 122 Annotation: Subtype: Link Rect: 291, 636, 298, 645 ActionDest: 122 Annotation: Subtype: Link Rect: 350, 611, 357, 620 ActionDest: 122 Annotation: Subtype: Link Rect: 357, 611, 364, 620 ActionDest: 122 Annotation: Subtype: Link Rect: 420, 548, 427, 557 ActionDest: 122 Annotation: Subtype: Link Rect: 430, 548, 437, 557 ActionDest: 122 Annotation: Subtype: Link Rect: 402, 473, 409, 482 ActionDest: 122 Annotation: Subtype: Link Rect: 402, 398, 409, 407 ActionDest: 122 Annotation: Subtype: Link Rect: 335, 322, 342, 331 ActionDest: 122 Annotation: Subtype: Link Rect: 272, 247, 279, 256 ActionDest: 122 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 333, 597, 340, 606 ActionDest: 122 Annotation: Subtype: Link Rect: 466, 481, 473, 493 ActionDest: 82 Annotation: Subtype: Link Rect: 194, 156, 201, 165 ActionDest: 122 Annotation: Subtype: Link Rect: 202, 156, 209, 165 ActionDest: 122 Annotation: Subtype: Link Rect: 209, 156, 216, 165 ActionDest: 122 Annotation: Subtype: Link Rect: 505, 118, 512, 127 ActionDest: 122 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 423, 571, 435, 580 ActionDest: 122 Annotation: Subtype: Link Rect: 448, 405, 559, 417 Annotation: Subtype: Link Rect: 545, 91, 552, 103 ActionDest: 96 Page: Sequence: 5 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 466, 670, 473, 681 ActionDest: 107 Annotation: Subtype: Link Rect: 239, 152, 246, 164 ActionDest: 110 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 552, 55, 559, 67 ActionDest: 113 Page: Sequence: 8 Annotations: Annotation: Subtype: Link Rect: 484, 669, 491, 681 ActionDest: 113 Annotation: Subtype: Link Rect: 275, 144, 282, 156 ActionDest: 116 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 483, 460, 495, 469 ActionDest: 122 Annotation: Subtype: Link Rect: 431, 422, 443, 431 ActionDest: 122 Annotation: Subtype: Link Rect: 419, 397, 431, 406 ActionDest: 122 Annotation: Subtype: Link Rect: 434, 397, 446, 406 ActionDest: 126 Annotation: Subtype: Link Rect: 460, 372, 472, 381 ActionDest: 126 Annotation: Subtype: Link Rect: 473, 372, 485, 381 ActionDest: 126 Annotation: Subtype: Link Rect: 469, 334, 481, 343 ActionDest: 126 Annotation: Subtype: Link Rect: 209, 284, 216, 293 ActionDest: 122 Annotation: Subtype: Link Rect: 242, 259, 253, 268 ActionDest: 126 Annotation: Subtype: Link Rect: 544, 234, 556, 243 ActionDest: 126 Annotation: Subtype: Link Rect: 536, 209, 543, 218 ActionDest: 122 Annotation: Subtype: Link Rect: 544, 209, 556, 218 ActionDest: 126 Annotation: Subtype: Link Rect: 246, 121, 258, 130 ActionDest: 126 Annotation: Subtype: Link Rect: 258, 121, 270, 130 ActionDest: 126 Annotation: Subtype: Link Rect: 281, 83, 293, 92 ActionDest: 126 Annotation: Subtype: Link Rect: 250, 58, 262, 67 ActionDest: 126 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 384, 697, 396, 706 ActionDest: 126 Annotation: Subtype: Link Rect: 397, 697, 409, 706 ActionDest: 126 Annotation: Subtype: Link Rect: 359, 659, 371, 669 ActionDest: 126 Annotation: Subtype: Link Rect: 190, 622, 202, 631 ActionDest: 126 Annotation: Subtype: Link Rect: 386, 572, 398, 581 ActionDest: 126 Annotation: Subtype: Link Rect: 387, 534, 399, 543 ActionDest: 126 Annotation: Subtype: Link Rect: 249, 408, 261, 417 ActionDest: 126 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 59, 503, 97, 513 Annotation: Subtype: Link Rect: 122, 469, 160, 479 Annotation: Subtype: Link Rect: 166, 469, 202, 479 Annotation: Subtype: Link Rect: 402, 445, 439, 456 Annotation: Subtype: Link Rect: 445, 445, 481, 456 Annotation: Subtype: Link Rect: 147, 422, 560, 433 Annotation: Subtype: Link Rect: 56, 410, 72, 421 Annotation: Subtype: Link Rect: 238, 376, 378, 387 Annotation: Subtype: Link Rect: 420, 353, 560, 364 Annotation: Subtype: Link Rect: 125, 318, 287, 329 Annotation: Subtype: Link Rect: 364, 295, 507, 306 Annotation: Subtype: Link Rect: 154, 250, 192, 260 Annotation: Subtype: Link Rect: 198, 250, 234, 260 Annotation: Subtype: Link Rect: 180, 226, 217, 237 Annotation: Subtype: Link Rect: 536, 203, 560, 214 Annotation: Subtype: Link Rect: 56, 192, 509, 203 Annotation: Subtype: Link Rect: 445, 157, 483, 168 Annotation: Subtype: Link Rect: 489, 157, 525, 168 Annotation: Subtype: Link Rect: 391, 134, 429, 145 Annotation: Subtype: Link Rect: 435, 134, 471, 145 Annotation: Subtype: Link Rect: 91, 89, 128, 99 Annotation: Subtype: Link Rect: 134, 89, 170, 99 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 118, 710, 155, 720 Annotation: Subtype: Link Rect: 162, 710, 198, 720 Annotation: Subtype: Link Rect: 426, 686, 464, 697 Annotation: Subtype: Link Rect: 470, 686, 506, 697 Annotation: Subtype: Link Rect: 298, 652, 336, 663 Annotation: Subtype: Link Rect: 59, 618, 97, 628 Annotation: Subtype: Link Rect: 103, 618, 139, 628 Annotation: Subtype: Link Rect: 140, 584, 178, 594 Annotation: Subtype: Link Rect: 184, 584, 220, 594 Annotation: Subtype: Link Rect: 223, 548, 560, 559 Annotation: Subtype: Link Rect: 56, 537, 200, 548 Annotation: Subtype: Link Rect: 183, 514, 560, 525 Annotation: Subtype: Link Rect: 56, 502, 270, 513 Annotation: Subtype: Link Rect: 211, 445, 248, 456 Annotation: Subtype: Link Rect: 254, 445, 290, 456 Annotation: Subtype: Link Rect: 193, 410, 230, 421 Annotation: Subtype: Link Rect: 237, 410, 273, 421 Annotation: Subtype: Link Rect: 307, 376, 345, 387 Annotation: Subtype: Link Rect: 351, 376, 387, 387 Annotation: Subtype: Link Rect: 520, 364, 557, 375 Annotation: Subtype: Link Rect: 59, 354, 95, 364 Annotation: Subtype: Link Rect: 378, 330, 415, 341 Annotation: Subtype: Link Rect: 421, 330, 457, 341 Annotation: Subtype: Link Rect: 136, 296, 173, 306 Annotation: Subtype: Link Rect: 179, 296, 215, 306 Annotation: Subtype: Link Rect: 245, 261, 283, 272 Annotation: Subtype: Link Rect: 289, 261, 325, 272 Annotation: Subtype: Link Rect: 299, 238, 336, 249 Annotation: Subtype: Link Rect: 342, 238, 379, 249 Checksum: 690bd3aa Type: CRC32 Checksum: 71f7e95709c2f6d87cb46c622d0041be Type: MD5 Checksum: 6ab22a09242fae6ae8894c041789f8c725dcd135 Type: SHA-1