Impact of Influenza Vaccination on Mortality in the Oldest Old: A Propensity Score-Matched Cohort Study

Influenza remains a major cause of illness and death in geriatric populations. While the influenza vaccine has successfully reduced morbidity and mortality, its effectiveness is suspected to decrease with age. The aim of this study was to assess the impact of influenza vaccination on all-cause mortality in very old ambulatory subjects. We conducted a prospective cohort study from 1 July 2016 to 31 June 2017 in a large unselected ambulatory population aged over 80 years. We compared all-cause mortality in vaccinated versus unvaccinated subjects after propensity-score matching, to control for age, sex and comorbidities. Among the 9149 patients included, with mean age 86 years, 4380 (47.9%) were vaccinated against influenza. In total, 5253 (57.4%) had at least one chronic disease. The most commonly vaccinated patients were those with chronic respiratory failure (76.3%) and the least commonly vaccinated were those suffering from Parkinson’s disease (28.5%). Overall, 2084 patients (22.8%) died during the study. After propensity score matching, the mortality was evaluated at 20.9% in the vaccinated group and 23.9% in the unvaccinated group (OR = 0.84 [0.75–0.93], p = 0.001). This decrease in mortality in the vaccinated group persisted whatever the age and Charlson Comorbidity index. In conclusion, nearly a half of this ambulatory elderly population received Influenza vaccine. After adjustment on comorbidities, influenza vaccination was associated with a significant decrease in all-cause mortality, even in the eldest multimorbid population. Improving immunization coverage in this frail older population is urgently needed.

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Impact of Pre-Existing Depression in Patients With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention; A Nationwide Cohort Study

10.21203/rs.3.rs-121586/v1 ◽

2020 ◽

Author(s):

Jangho Park ◽

Sangwoo Park ◽

Yong-Giun Kim ◽

Soe Hee Ann ◽

Hyun Woo Park ◽

...

Keyword(s):

Coronary Artery Disease ◽

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Propensity Score ◽

Propensity Score Matching ◽

Coronary Intervention ◽

Percutaneous Coronary ◽

All Cause Mortality ◽

Artery Disease ◽

The Impact

Abstract The impact of pre-existing depression on mortality in individuals with established coronary artery disease (CAD) remains unclear. We evaluate the clinical implications of pre-existing depression in patients who underwent percutaneous coronary intervention (PCI). Based on National Health Insurance claims data in Korea, patients without a known history of CAD who underwent PCI between 2013 and 2017 were enrolled. The study population was divided into patients with angina (n=50,256) or acute myocardial infarction (AMI; n=40,049). The primary endpoint, defined as all-cause death, was compared between the non-depression and depression groups using propensity score matching analysis. After propensity score matching, there were 4,262 and 2,346 matched pairs of patients with angina and AMI, respectively. During the follow-up period, there was no significant difference in the incidence of all-cause death in the angina (hazard ratio [HR] of depression, 1.013; 95% confidence interval [CI]: 0.893-1.151) and AMI (HR, 0.991; 95% CI: 0.865-1.136) groups. However, angina patients less than 65 years of age with depression had higher all-cause mortality (HR, 1.769; 95% CI: 1.240-2.525). In Korean patients undergoing PCI, pre-existing depression is not associated with poorer clinical outcomes. However, in younger patients with angina, depression is associated with higher all-cause mortality.

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Antifibrotic treatment improves clinical outcomes in patients with idiopathic pulmonary fibrosis: a propensity score matching analysis

Scientific Reports ◽

10.1038/s41598-020-72607-1 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Jieun Kang ◽

Minkyu Han ◽

Jin Woo Song

Keyword(s):

Propensity Score ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Propensity Score Matching ◽

Acute Exacerbation ◽

Propensity Score Matching Analysis ◽

Cox Proportional Hazard ◽

All Cause Mortality ◽

Related Hospitalisation ◽

The Impact

Abstract In patients with idiopathic pulmonary fibrosis (IPF), the effects of antifibrotic agents on the prognosis remain unclear. This study aimed to investigate the impact of antifibrotic treatment on the risks of mortality, hospitalisation, and acute exacerbation in real-world patients with IPF. A total of 1213 IPF patients (biopsy-proven cases: 405) were included in this retrospective study. Propensity score matching was used to adjust for differences in baseline characteristics between patients who received antifibrotic treatment and who did not. A Cox proportional hazard model was used to compare the risks of all-cause mortality, hospitalisation, acute exacerbation, and mortality following acute exacerbation between the two groups. From the 1213 patients, 474 matched pairs were generated. The mean age of the patients in the matched cohort was 65.8 years and 82.8% were men. The median follow-up duration was 27 months. Antifibrotic treatment significantly reduced the risks of mortality [hazard ratio (HR), 0.59; 95% confidence interval (CI), 0.48–0.72; p < 0.001], all-cause hospitalisation (HR 0.71), respiratory-related hospitalisation (HR 0.67), acute exacerbation (HR 0.69), and mortality after acute exacerbation (HR 0.60). Our results suggest that antifibrotic treatment may reduce the risks of all-cause mortality, hospitalisation, acute exacerbation, and mortality after acute exacerbation in patients with IPF.

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Pre-existing depression in patients with coronary artery disease undergoing percutaneous coronary intervention

Scientific Reports ◽

10.1038/s41598-021-87907-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Jangho Park ◽

Sangwoo Park ◽

Yong-Giun Kim ◽

Soe Hee Ann ◽

Hyun Woo Park ◽

...

Keyword(s):

Coronary Artery Disease ◽

Percutaneous Coronary Intervention ◽

Coronary Artery ◽

Propensity Score ◽

Propensity Score Matching ◽

Coronary Intervention ◽

Percutaneous Coronary ◽

All Cause Mortality ◽

Artery Disease ◽

The Impact

AbstractThe impact of pre-existing depression on mortality in individuals with established coronary artery disease (CAD) remains unclear. We evaluate the clinical implications of pre-existing depression in patients who underwent percutaneous coronary intervention (PCI). Based on National Health Insurance claims data in Korea, patients without a known history of CAD who underwent PCI between 2013 and 2017 were enrolled. The study population was divided into patients with angina (n = 50,256) or acute myocardial infarction (AMI; n = 40,049). The primary endpoint, defined as all-cause death, was compared between the non-depression and depression groups using propensity score matching analysis. After propensity score matching, there were 4262 and 2346 matched pairs of patients with angina and AMI, respectively. During the follow-up period, there was no significant difference in the incidence of all-cause death in the angina (hazard ratio [HR] of depression, 1.013; 95% confidence interval [CI] 0.893–1.151) and AMI (HR, 0.991; 95% CI 0.865–1.136) groups. However, angina patients less than 65 years of age with depression had higher all-cause mortality (HR, 1.769; 95% CI 1.240–2.525). In Korean patients undergoing PCI, pre-existing depression is not associated with poorer clinical outcomes. However, in younger patients with angina, depression is associated with higher all-cause mortality.

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Erratum to “The impact of nutrition support on clinical outcome and cost-effectiveness analysis in patients at nutritional risk: a prospective cohort study with propensity score matching,” Nutrition (2017) 37C, 53–59

Nutrition ◽

10.1016/j.nut.2017.04.001 ◽

2017 ◽

Vol 42 ◽

pp. 121

Keyword(s):

Cohort Study ◽

Cost Effectiveness ◽

Propensity Score ◽

Clinical Outcome ◽

Propensity Score Matching ◽

Prospective Cohort ◽

Nutrition Support ◽

Nutritional Risk ◽

Effectiveness Analysis ◽

The Impact

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Protective Effect of Seasonal Influenza Vaccination in Elderly Individuals with Disability in Taiwan: A Propensity Score–Matched, Nationwide, Population-Based Cohort Study

Vaccines ◽

10.3390/vaccines8010140 ◽

2020 ◽

Vol 8 (1) ◽

pp. 140

Author(s):

Yu-Chia Chang ◽

Huang Yu-Tung ◽

Long-Sheng Chen ◽

Ho-Jui Tung ◽

Kuang-Hua Huang ◽

...

Keyword(s):

Cohort Study ◽

Length Of Stay ◽

Propensity Score ◽

Protective Effect ◽

Influenza Vaccination ◽

Population Based ◽

Medical Expenditure ◽

Research Database ◽

Elderly Individuals ◽

All Cause Mortality

This is the first and largest population-based cohort study to demonstrate that influenza vaccination reduced all-cause mortality and influenza-related hospitalization in elderly individuals with a disability. Purpose: To estimate the protective effect of influenza vaccination in elderly individuals with a disability by conducting a propensity score-matched (PSM), nationwide, population-based cohort study. Methods: Data from Taiwan’s National Health Insurance Research Database were used in this study. Generalized estimating equations (GEEs) were used to compare outcomes between the vaccinated and unvaccinated cohorts. The GEE logit was used to estimate the relative risks of death and hospitalization after influenza vaccination. Adjusted odds ratios (aORs) were used to estimate relative risk. Results: The matching process yielded a final cohort of 272 896 elderly individuals with a disability (136 448 individuals in each cohort). In multivariate GEE analyses, aOR (vaccinated vs. unvaccinated) and 95% confidence interval (CI) of death were 0.70 (0.68–0.72). The aORs (95% CIs) of hospitalization for influenza and pneumonia, respiratory diseases, respiratory failure, heart disease, hemorrhagic stroke, and ischemic stroke were 0.98 (0.95–1.01), 0.96 (0.94–0.99), 0.85 (0.82–0.89), 0.96 (0.93–0.99), 0.85 (0.75–0.97), and 0.89 (0.84–0.95), respectively. The length of stay and medical expenditure exhibited greater reduction in vaccinated elderly individuals with a severe and very severe disability than in unvaccinated elderly individuals. Conclusions: Influenza vaccination reduced all-cause mortality, influenza-related hospitalization, length of stay, and medical expenditure in elderly individuals with a disability. The decrease in the length of stay and medical expenditure because of influenza vaccination was proportional to the severity of disability.

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Association of comorbidities with COVID-19 infection rate and severity: a nationwide cohort study with propensity score matching (Preprint)

10.2196/preprints.35025 ◽

2021 ◽

Author(s):

Jiyong Kim ◽

Seong Hun Park ◽

Jong Moon Kim

Keyword(s):

Cohort Study ◽

Propensity Score ◽

Propensity Score Matching ◽

Infection Rate ◽

Patient Demographics ◽

Propensity Matching ◽

The Disabled ◽

Severe Group ◽

Lower Infection ◽

The Impact

BACKGROUND Confirming the relationship between comorbidities and coronavirus infection-19 (COVID-19) is important for efficient use of medical facilities. OBJECTIVE This study investigated the impact of patient demographics and comorbidities on the infection rate and severity of COVID-19. METHODS Data were derived from a Korean nationwide cohort study with propensity score matching. We included 8070 individuals with positive covid-19 test and 12015 controls between January 1, 2020, and May 30, 2020. Outcomes were confirmation of the comorbidities affecting the infection rate and the severity of COVID-19. Endpoints were COVID-19 positivity and severe clinical outcomes of COVID-19 (tracheostomy, continuous renal replacement therapy, intensive care unit admission, ventilator use, cardiopulmonary resuscitation, or death). RESULTS In people aged 60 or older, in those insured with Medicaid, and in the disabled, the proportion corresponding to the severe group of patients showed a tendency to increase. The infection rate of COVID-19 was highest in pulmonary disease (adjusted odds ratio 1.88, 95% confidence interval 1.70 to 2.03), and hyperlipidemia (0.73, 0.67 to 0.80) had a lower infection rate. Disease severity was highest in kidney disease (5.59, 2.48 to 12.63), and lower in hyperlipidemia (0.78, 0.60 to 1.00). CONCLUSIONS Using propensity matching to reduce statistical bias, we found that most comorbidities increased the infection rate and severity of COVID-19, whereas hyperlipidemia reduced the rate and severity of infection. INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.1101/2021.09.22.21263946

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What is the effect of unemployment on all-cause mortality? A cohort study using propensity score matching

European Journal of Public Health ◽

10.1093/eurpub/cku136 ◽

2014 ◽

Vol 25 (1) ◽

pp. 115-121 ◽

Cited By ~ 21

Author(s):

Tom Clemens ◽

Frank Popham ◽

Paul Boyle

Keyword(s):

Cohort Study ◽

Propensity Score ◽

Propensity Score Matching ◽

All Cause Mortality

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PR interval prolongation and 1-year mortality among emergency department patients: a multicentre transnational cohort study

BMJ Open ◽

10.1136/bmjopen-2021-054238 ◽

2021 ◽

Vol 11 (12) ◽

pp. e054238

Author(s):

Rune Vad ◽

Tobias Malte Larsen ◽

Helene Kildegaard ◽

Mikkel Brabrand ◽

Jakob Lundager Forberg ◽

...

Keyword(s):

Emergency Department ◽

Cohort Study ◽

Propensity Score ◽

Propensity Score Matching ◽

Clinical Impact ◽

Interval Prolongation ◽

Risk Of Death ◽

Pr Interval ◽

All Cause Mortality ◽

Emergency Department Patients

ObjectivesEmerging evidence supports that PR interval prolongation is associated with increased mortality. However, most previous studies have limited confounder control, and clinical impact in a population of acute ill patients is unknown. The aim of this study was to investigate whether 1-year all-cause mortality was increased in patients presenting with PR interval prolongation in the emergency department (ED).Design and settingWe conducted a register-based cohort study in two Swedish and two Danish EDs. We included all adult patients with an ECG performed at arrival to the Danish EDs during March 2013 to May 2014 and Swedish EDs during January 2010 to January 2011. Using propensity score matching, we analysed HR for 1-year all-cause mortality comparing patients with PR interval prolongation (>200 ms) and normal PR interval (120–200 ms).Participants and resultsWe included 106 124 patients. PR interval prolongation occurred in 8.9% (95% CI 8.7% to 9.0%); these patients were older and had more comorbidity than those with a normal PR interval. The absolute 1-year risk of death was 13% (95% CI 12.3% to 13.7%) for patients with PR interval prolongation and 7.9% (95% CI 7.7% to 8.0%) for those without. After confounder adjustments by propensity score matching, PR interval prolongation showed no association with 1-year mortality with a HR of 1.00 (95% CI 0.93% to 1.08%).ConclusionPR interval prolongation does not constitute an independent risk factor for 1-year mortality in ED patients.

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