Chronic obstructive pulmonary disea...

Chronic obstructive pulmonary disease (COPD) is a used by all condition that has a significant negative impact onward morbidity and mortality rates and health care expenses Approximately one third of acute exacerbations of COPD may be caused at viral infections. These infections can lead to increased rates of bacterial infections. To combat viral infections, rife recommendations for management of COPD include annual influenza immunization. These recommendations are based forward observational studies that have shown that influenza immunizations change into the number of hospitalizations, decrease risk of pneumonia, and bring to mortality rates. Few data are available from randomized trials that evaluate influenza immunization in patients with COPD Wongsurakiat and colleagues studied the effectiveness of influenza vaccination onward influenza-related acute respiratory illness in patients with COPD

The trial was a stratified, randomized, double-blind, placebo-controlled thought of patients with COPD who regularly attended a university hospital's COPD clinic. Patients were included if they met spirometry criteria for COPD Participants were divided into mild, moderate, and unrelenting categories based on the severity of their disease, and then randomly assigned to receive active influenza vaccination or placebo. The issue measurements were the number and severity of total acute respiratory illnesses, based upon outpatient treatment, hospitalization, and mechanical ventilation requirement; and the number of episodes and severity of influenza-related acute respiratory illnesses.

A total of 125 patients participated in the thought The incidence of influenza-related acute respiratory illness was 281 by 100 person-years in the placebo arrange and 6.8 per 100 person-years in the vaccination cluster This difference was statistically significant and was base in all three severity assign places tos The vaccine effectiveness was 84 percent in patients with mild COPD 45 percent in the moderate dispose and 85 percent in the exact group. Bivariate analysis revealed that the effectiveness of the vaccine was no different based onward severity of COPD, comorbid dis-eases, age, sex or smoking status. Patients who received the vaccine were les likely to be hospitalized or placed upon a ventilator secondary to influenza-related acute respiratory illness. When evaluating the total acute respiratory illness incidence and severity, no difference was noted between participants who received the vaccine and those who received placebo. The probability of acquiring an influenza-related respiratory illness was significantly les in the vaccine assign places to compared with the placebo group

The authors bring to an end that influenza vaccination is highly effective in preventing influenza-related acute respiratory illness in patients with COPD regardless of the severity of their disease. They add that influenza vaccination should be praiseed to all patients who have COPD

Wongsurakiat P et al. Acute respiratory illness in patients with COPD and the effectiveness of influenza vaccination: a randomized controll cogitation Chest June 2004;125:2011-20.

EDITOR'S NOTE: Despite the recommendations for routine influenza immunization in various populations, a significant number of persons fail to receive this vaccine. In a latter report (1) from the Center for Disease have the direction of and Prevention (CDC), 66 percent of adults 65 years or older had received an influenza vaccination in the previous year. This is substantially below the 90 percent goal for 20101 The CDC approves system-based approaches (e.g., standing orders) to improve the percentage of patients receiving the influenza immunization.-K.E.M.

REFERENCE

(1) Center for Disease dominion government and Prevention. Public health and aging: influenza vaccination coverage among adults aged = 50 years and pneumococcal vaccination coverage among adults aged = 65 years-United States, 2002 Morb Mortal Wkly Rep MMWR 2003;52:987-92

COPYRIGHT 2005 American Academy of Family Physicians

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