流感疫苗接种对危重心房颤动患者全因死亡率的独立影响：来自MIMIC-IV数据库的回顾性研究

IF 3.2 2区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

International journal of cardiology Pub Date : 2025-04-11 DOI:10.1016/j.ijcard.2025.133246

Jian Lei , Ling-Zhao Zheng , Ke-Yuan Chen , Xi Yang , Yue Tian , Zhi-Huang Qiu , Liang-Wan Chen

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引用次数: 0

摘要

目的房颤（AF）在危重患者中很常见，且与较高的死亡率相关。流感疫苗接种对这一人群全因死亡率的影响尚不清楚。本研究评估流感疫苗接种对危重房颤患者死亡率的影响。方法采用MIMIC-IV数据库进行回顾性队列分析。采用Kaplan-Meier生存曲线和Cox比例风险模型（校正混杂因素）评估流感疫苗接种对死亡率的影响。使用处理加权逆概率（IPTW）和倾向评分匹配（PSM）来最小化选择偏差。亚组分析检查了重症监护病房（ICU）房颤患者的临床特征。结果12137例ICU房颤患者中，6554例（54.0%）接种了流感疫苗。接种疫苗与全因死亡率降低相关(28天风险比= 0.79,90天风险比= 0.83,365天风险比= 0.84；所有p值<；0.001)。经PSM和协变量调整后，流感疫苗接种仍然是更好结局的独立预测因子(28天HR = 0.83, 90天HR = 0.82, 365天HR = 0.84；所有p值<；0.001)。这些发现与IPTW分析一致。亚组分析显示，老年、高血压和非阵发性房颤患者获益更大。结论流感疫苗接种可提高危重房颤患者的生存率。这些发现支持疫苗接种作为ICU高危房颤患者的重要保护措施。

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Independent effect of influenza vaccination on all-cause mortality in critically ill patients with atrial fibrillation: A retrospective study from the MIMIC-IV database

Objective

Atrial fibrillation (AF) is common in critically ill patients and associated with higher mortality. The impact of influenza vaccination on all-cause mortality in this population is unclear. This study evaluates the effect of influenza vaccination on mortality in critically ill AF patients.

Methods

A retrospective cohort analysis was conducted using the MIMIC-IV database. The effect of influenza vaccination on mortality was assessed using Kaplan-Meier survival curves and Cox proportional hazards models, adjusted for confounders. Inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were used to minimize selection bias. Subgroup analyses examined clinical characteristics among AF patients in the intensive care unit (ICU).

Results

Among 12,137 ICU AF patients, 6554 (54.0 %) received the influenza vaccine. Vaccination was associated with reduced all-cause mortality (28-day hazard ratio [HR] = 0.79, 90-day HR = 0.83, 365-day HR = 0.84; all p-values <0.001). After PSM and covariate adjustment, influenza vaccination remained an independent predictor of better outcomes (28-day HR = 0.83, 90-day HR = 0.82, 365-day HR = 0.84; all p-values <0.001). These findings were consistent in IPTW analyses. Subgroup analyses showed greater benefits in elderly, hypertensive, and non-paroxysmal AF patients.

Conclusion

Influenza vaccination is associated with improved survival in critically ill AF patients. These findings support vaccination as a crucial protective measure for high-risk AF patients in the ICU.

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来源期刊

International journal of cardiology 医学-心血管系统

CiteScore

6.80

自引率

5.70%

发文量

758

审稿时长

44 days

期刊介绍： The International Journal of Cardiology is devoted to cardiology in the broadest sense. Both basic research and clinical papers can be submitted. The journal serves the interest of both practicing clinicians and researchers. In addition to original papers, we are launching a range of new manuscript types, including Consensus and Position Papers, Systematic Reviews, Meta-analyses, and Short communications. Case reports are no longer acceptable. Controversial techniques, issues on health policy and social medicine are discussed and serve as useful tools for encouraging debate.