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Table 3 Pooled crude and adjusted odd ratios (OR) for influenza-related outcomes during influenza-season and off-season in vaccinated vs. non-vaccinated end-stage renal disease participants

From: Influenza vaccination in patients with end-stage renal disease: systematic review and assessment of quality of evidence related to vaccine efficacy, effectiveness, and safety

Outcome

Author [Ref]

Crude OR (95% CI)

Adjusted OR (95% CI)

Off-season adjusted OR (95% CI)

Risk of bias

Mortality

     

All-cause mortality

    
 

Bond et al.1 [25]

0.79 (0.72–0.87)

0.73 (0.67–0.81)2

0.90 (0.77–1.10)2

Unclear

 

Gilbertson3 [24]

–

0.77 (0.65–0.90)4

 

High

 

McGrath [26]

0.77 (0.76–0.78)5

0.71 (0.70–0.72)5

0.45 (0.41–0.50)6

High

 

Wang [23]

0.88 (0.73–1.07)7

0.49 (0.41–0.59)7

–

High

 

Pooled estimate

0.77 (0.75–0.80), I2 = 10%

0.68 (0.61–0.76), I2 = 83%

–

–

Cardiac death #

     
 

Gilbertson3 [24]

–

0.84 (0.71–0.98)4

–

High

Infectious death §

    
 

Gilbertson3 [24]

–

0.83 (0.65–1.05)4

–

High

Hospitalization

     

All-cause hospitalization

    
 

Gilbertson3 [24]

–

0.95 (0.85–1.07)4

 

High

 

Wang [23]

1.11 (0.96–1.28)7

0.80 (0.69–0.94)7

–

High

 

Pooled estimate

–

0.88 (0.74–1.04), I2 = 70%

–

–

Hospitalization due to influenza or pneumonia

   
 

Gilbertson3 [24]

–

0.90 (0.70–1.16)4

 

High

 

McGrath [26]

0.90 (0.87–0.92)5

0.84 (0.82–0.84)5

0.74 (0.64–0.85)6

High

 

Slinin [27]

–

0.93 (0.86–1.01)

–

High

 

Wang [23]

1.30 (1.08–1.56)7

0.77 (0.64–0.93)7

–

High

 

Pooled estimate

1.07 (0.75–1.53), I2 = 93%

0.86 (0.80–0.93), I2 = 58%

 

–

Hospitalization due to bacteremia, viremia, or septicemia

    
 

Gilbertson3 [24]

–

0.73 (0.32–1.68)4

–

High

Hospitalization due to respiratory infection

    
 

Gilbertson3 [24]

–

0.87 (0.69–1.09)4

–

High

ICU admission

     
 

Wang [23]

0.38 (0.27–0.53)7

0.19 (0.14–0.27)7

–

High

Other outcomes

     

Influenza-like illness

     
 

McGrath [26]

0.93 (0.91–0.95)5

0.88 (0.86–0.90)5

0.77 (0.68–0.88)6

High

  1. OR, odds ratio; ICU, intensive care unit.
  2. #Cardiac death, defined according to cause of death reported on the ESRD death notification form (myocardial infarction, pericarditis, atherosclerotic heart disease, cardiomyopathy, cardiac arrhythmia, cardiac arrest, valvular heart disease, pulmonary edema).
  3. #Infectious death, defined according to cause of death reported on the ESRD death notification form (septicemia, pulmonary infection, viral infection, tuberculosis, hepatitis B, other viral hepatitis, fungal peritonitis, other infections).
  4. 1OR were also reported for those who additionally received pneumococcal vaccine; however, for the purpose of this study these patients were not considered.
  5. 2Off-season estimates in months June–August.
  6. 3Only patients on peritoneal dialysis.
  7. 4Point estimates of two influenza seasons were pooled first.
  8. 5Point estimates of four seasons were pooled first.
  9. 6Point estimates of four pre-influenza-seasons (defined as 10% of isolates positive for influenza) were pooled first.
  10. 7Crude/Adjusted incidence rate ratios.