Clinical Outcomes of Acute Exacerbation of Copd in Influenza According to Vaccination Status in Patients Above Age 65 Years

Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality in the elderly, with acute exacerbations frequently triggered by respiratory infections such as influenza. Vaccination against influenza is globally recommended in this population; however, real-world evidence regarding its impact on clinical outcomes remains limited in low-resource settings. Objective: To assess and compare clinical outcomes, particularly in-hospital mortality and length of hospital stay, in elderly patients (≥65 years) with acute exacerbation of COPD, based on their influenza vaccination status. Methods: This descriptive study was conducted at the Department of Medicine, Khyber Teaching Hospital, Peshawar, over a 6-month period. A total of 112 patients aged 65 to 80 years, hospitalized with acute COPD exacerbation, were enrolled and divided equally into vaccinated and unvaccinated groups based on verified influenza vaccination status. Key outcomes included in-hospital mortality and prolonged hospital stay (>5 days). Data were collected prospectively and analyzed using SPSS v24, with p≤0.05 considered statistically significant. Results: Among the vaccinated group (n=56), in-hospital mortality was 5.4% compared to 16.1% in the unvaccinated group. Prolonged hospital stays were observed in 12.5% of vaccinated patients versus 32.1% in unvaccinated patients. The mean hospital stay was significantly shorter in vaccinated individuals (4.2 ± 1.6 days) than in the unvaccinated group (6.3 ± 2.4 days), indicating a clear protective association of influenza vaccination. Conclusion: Influenza vaccination was significantly associated with reduced mortality and shorter hospital stays in elderly COPD patients experiencing acute exacerbations. These findings reinforce the urgent need to improve vaccination coverage in high-risk elderly populations.