Mortality of dialysis patients according to influenza and pneumococcal vaccination status
T Christopher Bond1, Anne C Spaulding, Jenna Krisher
1Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30340, USA. tcbphd2@gmail.com
Background:
Data from an immunocompromised subpopulation in which both vaccine recipients and nonrecipients have frequent opportunities for vaccination can help determine the associations between vaccination against seasonal influenza and pneumococcal disease and all-cause mortality.
Study Design:
We surveyed dialysis centers and performed a retrospective analysis of health status at dialysis therapy initiation, vaccination for influenza and pneumococcal disease, laboratory results, and mortality associated with the 2005-2006 influenza season for patients in 3 End-Stage Renal Disease Networks across the United States.
Setting & Participants:
Of 1,033 dialysis facilities considered, 903 centers with a total patient population of 54,734 reported vaccination data. Analysis was limited to 36,966 patients on dialysis treatment for at least 1 year as of December 31, 2005.
Predictor:
Vaccination status.
Outcomes:
OR for all-cause mortality (vaccinated vs unvaccinated patients).
Results:
The estimated adjusted OR for mortality was significantly less than 1.0 for patient who received either vaccination and was lower for patients who had received both vaccinations than for those who had received either. Survival analysis confirmed these findings.
Limitations:
Possible misclassification due to self-report of vaccination for some patients. Lack of vaccination date.
Conclusions:
Vaccination against influenza and pneumococcal disease is associated with improved survival in dialysis patients. The 2 vaccinations have independent effects on mortality.
Related Concept Videos
01:30Pneumonia V: Nursing management and Prevention
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
01:30Pneumonia III: Complications and Assessment
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pneumonia I: Introduction