Impact of influenza and pneumococcal vaccines upon in-hospital mortality in patients with heart failure: a retrospective cohort study in the United States

Abstract Introduction Heart failure has been increasing in prevalence over the past decade. Respiratory infections have been associated with exacerbations of underlying heart failure. Hence, vaccinations against these infections may serve to be an effective intervention to improve overall outcomes. Purpose We sought to compare the in-hospital mortality in patients with heart failure who received influenza and pneumococcal vaccine. Methods We analysed the United States National Inpatient Sample Database from 2010–2014 to identify patients with primary discharge diagnosis of heart failure. We identified pneumococcal vaccine with ICD 9 code V03.82 and influenza vaccine with ICD-9 code V04. 81. We excluded patients who were transferred out to prevent duplication of data. Chi-Square test was used for statistical analysis. Results The sample consisted of 587,018 patients with heart failure from 2010 to 2014 (Mage= 70.53±14.6 years), the majority of whom were male (60.1%) and Caucasian (53.2%). Upon comparing the group that received the influenza vaccine to the group that did not receive the influenza vaccine, rates of in-hospital mortality in patients with heart failure were 1.3% vs 3.6%; p0.001. Furthermore, comparison of the group that received pneumococcal vaccine to the group that did not receive the pneumococcal vaccine, rates of in-hospital mortality were 1.2% vs 3.6%; p0.001. Conclusions Despite the growing awareness regarding vaccinations in patients with heart failure the rates of vaccination in heart failure patients remain low. Our study findings indicate that patients who received influenza and pneumococcal vaccine had lower in-hospital mortality. The results of our study indicate that these vaccines have a significant impact in improving outcomes in heart failure patients. Funding Acknowledgement Type of funding source: None