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Effectiveness of influenza vaccination in patients with end-stage renal disease receiving hemodialysis: a population-based study.

Abstract

BACKGROUND

Little is known on the effectiveness of influenza vaccine in ESRD patients. This study compared the incidence of hospitalization, morbidity, and mortality in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) between cohorts with and without influenza vaccination.

METHODS

We used the insurance claims data from 1998 to 2009 in Taiwan to determine the incidence of these events within one year after influenza vaccination in the vaccine (N = 831) and the non-vaccine (N = 3187) cohorts. The vaccine cohort to the non-vaccine cohort incidence rate ratio and hazard ratio (HR) of morbidities and mortality were measured.

RESULTS

The age-specific analysis showed that the elderly in the vaccine cohort had lower hospitalization rate (100.8 vs. 133.9 per 100 person-years), contributing to an overall HR of 0.81 (95% confidence interval (CI) 0.72-0.90). The vaccine cohort also had an adjusted HR of 0.85 [95% CI 0.75-0.96] for heart disease. The corresponding incidence of pneumonia and influenza was 22.4 versus 17.2 per 100 person-years, but with an adjusted HR of 0.80 (95% CI 0.64-1.02). The vaccine cohort had lowered risks than the non-vaccine cohort for intensive care unit (ICU) admission (adjusted HR 0.20, 95% CI 0.12-0.33) and mortality (adjusted HR 0.50, 95% CI 0.41-0.60). The time-dependent Cox model revealed an overall adjusted HR for mortality of 0.30 (95% CI 0.26-0.35) after counting vaccination for multi-years.

CONCLUSIONS

ESRD patients with HD receiving the influenza vaccination could have reduced risks of pneumonia/influenza and other morbidities, ICU stay, hospitalization and death, particularly for the elderly.

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  • Authors+Show Affiliations

    ,

    Graduate Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan.

    , , , , , , , ,

    Source

    PloS one 8:3 2013 pg e58317

    MeSH

    Adolescent
    Adult
    Aged
    Aged, 80 and over
    Comorbidity
    Female
    Hospital Mortality
    Hospitalization
    Humans
    Incidence
    Influenza Vaccines
    Influenza, Human
    Kidney Failure, Chronic
    Male
    Middle Aged
    Morbidity
    Population Surveillance
    Proportional Hazards Models
    Renal Dialysis
    Risk
    Taiwan
    Vaccination
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    23516462

    Citation

    Wang, I-Kuan, et al. "Effectiveness of Influenza Vaccination in Patients With End-stage Renal Disease Receiving Hemodialysis: a Population-based Study." PloS One, vol. 8, no. 3, 2013, pp. e58317.
    Wang IK, Lin CL, Lin PC, et al. Effectiveness of influenza vaccination in patients with end-stage renal disease receiving hemodialysis: a population-based study. PLoS ONE. 2013;8(3):e58317.
    Wang, I. K., Lin, C. L., Lin, P. C., Liang, C. C., Liu, Y. L., Chang, C. T., ... Sung, F. C. (2013). Effectiveness of influenza vaccination in patients with end-stage renal disease receiving hemodialysis: a population-based study. PloS One, 8(3), pp. e58317. doi:10.1371/journal.pone.0058317.
    Wang IK, et al. Effectiveness of Influenza Vaccination in Patients With End-stage Renal Disease Receiving Hemodialysis: a Population-based Study. PLoS ONE. 2013;8(3):e58317. PubMed PMID: 23516462.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Effectiveness of influenza vaccination in patients with end-stage renal disease receiving hemodialysis: a population-based study. AU - Wang,I-Kuan, AU - Lin,Cheng-Li, AU - Lin,Po-Chang, AU - Liang,Chih-Chia, AU - Liu,Yao-Lung, AU - Chang,Chiz-Tzung, AU - Yen,Tzung-Hai, AU - Morisky,Donald E, AU - Huang,Chiu-Ching, AU - Sung,Fung-Chang, Y1 - 2013/03/13/ PY - 2012/10/24/received PY - 2013/02/01/accepted PY - 2013/3/22/entrez PY - 2013/3/22/pubmed PY - 2013/9/13/medline SP - e58317 EP - e58317 JF - PloS one JO - PLoS ONE VL - 8 IS - 3 N2 - BACKGROUND: Little is known on the effectiveness of influenza vaccine in ESRD patients. This study compared the incidence of hospitalization, morbidity, and mortality in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD) between cohorts with and without influenza vaccination. METHODS: We used the insurance claims data from 1998 to 2009 in Taiwan to determine the incidence of these events within one year after influenza vaccination in the vaccine (N = 831) and the non-vaccine (N = 3187) cohorts. The vaccine cohort to the non-vaccine cohort incidence rate ratio and hazard ratio (HR) of morbidities and mortality were measured. RESULTS: The age-specific analysis showed that the elderly in the vaccine cohort had lower hospitalization rate (100.8 vs. 133.9 per 100 person-years), contributing to an overall HR of 0.81 (95% confidence interval (CI) 0.72-0.90). The vaccine cohort also had an adjusted HR of 0.85 [95% CI 0.75-0.96] for heart disease. The corresponding incidence of pneumonia and influenza was 22.4 versus 17.2 per 100 person-years, but with an adjusted HR of 0.80 (95% CI 0.64-1.02). The vaccine cohort had lowered risks than the non-vaccine cohort for intensive care unit (ICU) admission (adjusted HR 0.20, 95% CI 0.12-0.33) and mortality (adjusted HR 0.50, 95% CI 0.41-0.60). The time-dependent Cox model revealed an overall adjusted HR for mortality of 0.30 (95% CI 0.26-0.35) after counting vaccination for multi-years. CONCLUSIONS: ESRD patients with HD receiving the influenza vaccination could have reduced risks of pneumonia/influenza and other morbidities, ICU stay, hospitalization and death, particularly for the elderly. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/23516462/Effectiveness_of_influenza_vaccination_in_patients_with_end_stage_renal_disease_receiving_hemodialysis:_a_population_based_study_ L2 - http://dx.plos.org/10.1371/journal.pone.0058317 DB - PRIME DP - Unbound Medicine ER -