Dataset Information

Influenza Vaccination and Risk of Stroke in Women With Chronic Obstructive Pulmonary Disease: A Nationwide, Population-Based, Propensity-Matched Cohort Study.

ABSTRACT:

Backgrounds

The risk of stroke is higher among patients with chronic obstructive pulmonary disease (COPD) than among the healthy population. Moreover, women generally have worse long-term stroke outcomes than men.

Methods

The data of 6681 women with COPD (aged ≥ 65 years) registered in Taiwan's National Health Insurance Research Database were retrospectively analyzed from January 1, 2001 to December 31, 2011. After 1:1 propensity score matching, the patients were divided into vaccinated and unvaccinated groups.

Results

In total, 5102 women were enrolled. The vaccinated group had a significantly lower risk of total, hemorrhagic, and ischemic stroke than the unvaccinated group (adjusted hazard ratio [aHR]: 0.60, 95% confidence interval [CI]: 0.54-0.67; aHR: 0.59, 95% CI: 0.43-0.83; and aHR: 0.59, 95% CI: 0.52-0.68, respectively). A lower risk of stroke was observed among the women aged 65-74 and ≥75 years, and the association was dose-dependent in all types of stroke (aHR: 1.08, 95% CI: 0.92-1.26; aHR: 0.70, 95% CI: 0.60-0.82; and aHR: 0.32, 95% CI: 0.26-0.38 for those vaccinated 1, 2 to 3, and ≥4 times, respectively, during the follow-up period). Women with a CHA₂DS₂-VASc score (conditions and characteristics included congestive heart failure, hypertension, diabetes, stroke, vascular disease, age, and sex) of 2-3 and ≥4 had a significantly lower risk of ischemic stroke while receiving more vaccinations. A smaller significant lower risk of hemorrhagic stroke after more than 4 times of vaccination was noted in the women with a CHA₂DS₂-VASc score of ≥4. Both interrupted and non-interrupted vaccination was associated with lower risk of stroke occurrence.

Conclusion

Influenza vaccination is associated with a lower risk of total, hemorrhagic, and ischemic stroke among women with COPD, and the association is dose-dependent. However, the findings may be limited by unmeasurable confounders. Further investigations on this subject are warranted.

SUBMITTER: Chen CC

PROVIDER: S-EPMC9160371 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Influenza Vaccination and Risk of Stroke in Women With Chronic Obstructive Pulmonary Disease: A Nationwide, Population-Based, Propensity-Matched Cohort Study.

Chen Chun-Chao CC Lin Cheng-Hsin CH Chiu Chun-Chih CC Yang Tsung Yeh TY Hsu Min-Huei MH Wang Yuan-Hung YH Lei Meng-Huan MH Yeh Hsien Tang HT Fang Yu-Ann YA Hao Wen-Rui WR Liu Ju-Chi JC

Frontiers in medicine 20220519

<h4>Backgrounds</h4>The risk of stroke is higher among patients with chronic obstructive pulmonary disease (COPD) than among the healthy population. Moreover, women generally have worse long-term stroke outcomes than men.<h4>Methods</h4>The data of 6681 women with COPD (aged ≥ 65 years) registered in Taiwan's National Health Insurance Research Database were retrospectively analyzed from January 1, 2001 to December 31, 2011. After 1:1 propensity score matching, the patients were divided into vacc ...[more]

PMID: 35665329

Similar Datasets

Project description:RationaleChronic obstructive pulmonary disease (COPD) has been identified as a risk factor for cardiovascular diseases such as myocardial infarction. The role of COPD in cerebrovascular disease is, however, less certain. Although earlier studies have suggested that the risk for stroke is also increased in COPD, more recent investigations have generated mixed results.ObjectivesThe primary objective of our review was to quantify the magnitude of the association between COPD and stroke. We also sought to clarify the nature of the relationship between COPD and stroke by investigating whether the risk of stroke in COPD varies with age, sex, smoking history, and/or type of stroke and whether stroke risk is modified in particular COPD phenotypes.ResultsThe MEDLINE and EMBASE databases were searched in May 2016 to identify articles that compared stroke outcomes in people with and without COPD. Studies were grouped by study design to distinguish those that reported prevalence of stroke (cross-sectional studies) from those that estimated incidence (cohort or case-control studies). In addition, studies were stratified according to study population characteristics, the nature of COPD case definitions, and adjustment for confounding (smoking). Heterogeneity was assessed using the I2 statistic. We identified 5,493 studies, of which 30 met our predefined inclusion criteria. Of the 25 studies that reported prevalence ratios, 11 also estimated prevalence odds ratios. The level of heterogeneity among the included cross-sectional studies did not permit the calculation of pooled ratios, save for a group of four studies that estimated prevalence odds ratios adjusted for smoking (prevalence odds ratio, 1.51; 95% confidence interval, 1.09-2.09; I2 = 45%). All 11 studies that estimated relative risk for nonfatal incident stroke reported increased risk in COPD. Adjustment for smoking invariably reduced the magnitude of the associations.ConclusionsAlthough both prevalence and incidence of stroke are increased in people with COPD, the weight of evidence does not support the hypothesis that COPD is an independent risk factor for stroke. The possibility remains that COPD is causal in certain subsets of patients with COPD and for certain stroke subtypes.

Dataset Information

Influenza Vaccination and Risk of Stroke in Women With Chronic Obstructive Pulmonary Disease: A Nationwide, Population-Based, Propensity-Matched Cohort Study.

Backgrounds

Methods

Results

Conclusion

Publications

Influenza Vaccination and Risk of Stroke in Women With Chronic Obstructive Pulmonary Disease: A Nationwide, Population-Based, Propensity-Matched Cohort Study.

Similar Datasets

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