Sohal Aalam, Kohli Isha, Chaudhry Hunza, Singh Ishandeep, Arora Kirti, Kalra Shivam, Dukovic Dino, Roytman Marina
Department of Hepatology, Liver Institute Northwest, 3216 NE 45Th Pl, Suite 212, Seattle, WA, 98105, USA.
Graduate Program in Public Health, Icahn School of Medicine, Mount Sinai, New York, NY, USA.
Dig Dis Sci. 2024 Feb;69(2):588-595. doi: 10.1007/s10620-023-08202-x. Epub 2023 Nov 29.
Liver transplant recipients (LTR) and patients with chronic liver disease (CLD) are at an increased risk of infections.
The objective of our study was to assess the incidence, and impact of vaccine preventable illness (VPI) on outcomes in LTR.
National Inpatient Sample (NIS) 2016-2020 was used to identify adults (age > 18) hospitalized LTR using ICD-10 codes. Data were collected on patient demographics, hospital characteristics, etiology of liver disease, hepatic decompensations and outcomes. Patients were stratified into two groups based on the presence or absence of VPI. Multivariate logistic regression analysis was performed to identify the association between VPI and outcomes.
Out of 170,650 hospitalized LTR, 13.5% of the patients had VPI. The most common VPI was noted to be influenza (10.7%), followed by pneumococcal infection (2.7%). Incidence of mortality (6.9% vs. 1.6%, p < 0.001), ICU admissions (14.3% vs. 3.4%, p < 0.001), and acute kidney injury (AKI) (43.7% vs 37.35%, p < 0.001) was higher in the VPI group.
More than 13% of the LT hospitalizations had concomitant VPI. VPI in LTR was associated with worse outcomes. Our data suggests the need to identify factors associated with reduced vaccination rates and identify strategies to improve vaccination rates and responses in these patients.
肝移植受者（LTR）和慢性肝病（CLD）患者感染风险增加。
我们研究的目的是评估疫苗可预防疾病（VPI）在肝移植受者中的发病率及其对预后的影响。
使用2016 - 2020年国家住院患者样本（NIS），通过国际疾病分类第十版（ICD - 10）编码识别成年（年龄>18岁）住院肝移植受者。收集患者人口统计学、医院特征、肝病病因、肝失代偿和预后的数据。根据是否存在VPI将患者分为两组。进行多因素逻辑回归分析以确定VPI与预后之间的关联。
在170,650例住院肝移植受者中，13.5%的患者患有VPI。最常见的VPI是流感（10.7%），其次是肺炎球菌感染（2.7%）。VPI组的死亡率（6.9%对1.6%，p<0.001）、重症监护病房（ICU）入院率（14.3%对3.4%，p<0.001）和急性肾损伤（AKI）发生率（43.7%对37.35%，p<0.001）更高。
超过13%的肝移植住院患者伴有VPI。肝移植受者中的VPI与更差的预后相关。我们的数据表明需要确定与疫苗接种率降低相关的因素，并确定提高这些患者疫苗接种率和反应的策略。
