1. From a cohort study, surgical patients who were vaccinated preoperatively were not at a higher risk for inpatient visits, emergency department visits or post-discharge fever.
Evidence Rating Level: 2 (Good)
Study Rundown: According to the most recent CDC guidelines, the influenza vaccine should be administered to everyone aged 6 months or older on an annual basis. Hospital visits are an excellent time for patients to receive the vaccine as part of their care; however, providers have shown concerns that the vaccine’s side effects could be misinterpreted as post-operative complications in surgical patients. This retrospective cohort study compared the rates of outpatient, inpatient and emergency department (ED) visits in the first week after discharge between surgical patients who received the flu vaccine and those who did not receive it. Rates of post-discharge fever and infection work-up were also compared between the two groups. The findings demonstrated no significant difference in relative risk of further ED visits, readmissions, post-discharge fevers or clinical work-ups of infection between the two groups. There was a slight increase in outpatient visits during the first seven days after discharge for the vaccinated group. This study is limited in that it did not assess outcomes past seven days post-discharge, and it did not distinguish between planned and unplanned readmissions or outpatient visits. Overall, these data suggest that surgical patients who receive the flu vaccine may not be at an increased risk for further complications.
In-Depth [retrospective cohort study]: Surgical inpatients of the Kaiser Permanente Southern California (KPSC) healthcare system aged 6 months or older and eligible for an influenza vaccination were included in this study. The primary outcomes included rates of outpatient, inpatient and ED visits in the first week after discharge. Rates of fever and clinical work-up for infection in the first week following discharge were also assessed. There were 42,777 surgeries included in the adjusted analyses, and the flu vaccine was administered in 6,420 (15.0%). There were no significant differences between vaccinated and unvaccinated patients in terms of inpatient visits (RR 1.12; 95%CI 0.96 to 1.32), ED visits (RR 1.07; 95%CI 0.96 to 1.20), fever (RR 1.00; 95%CI 0.76 to 1.31) or clinical work-ups for infection (RR 1.06; 95%CI 0.99 to 1.13) during the first week after discharge. A slightly increased risk of outpatient visits was observed in the vaccinated cohort (RR 1.05; CI 1.00 to 1.10; p = 0.032).
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