title: Risk of cardiovascular events after infection-related hospitalizations in older patients on dialysis.
abstract: OBJECTIVE
  Infection and cardiovascular disease are leading causes of hospitalization and death in patients on dialysis. The objective of this study was to determine whether an infection-related hospitalization increased the short-term risk of a cardiovascular event in older patients on dialysis.
  
  
  METHODS
  With use of the United States Renal Data System, patients aged 65 to 100 years who started dialysis between January 1, 2000, and December 31, 2002, were examined. All hospitalizations were examined from study entry until time of transplant, death, or December 31, 2004. All discharge diagnoses were examined to determine if an infection occurred during hospitalization. Only principal discharge diagnoses were examined to ascertain cardiovascular events of interest. We used the self-controlled case-series method to estimate the relative incidence of a cardiovascular event within 90 days after an infection-related hospitalization as compared with other times not within 90 days of such a hospitalization.
  
  
  RESULTS
  A total of 16,874 patients had at least one cardiovascular event and were included in the self-controlled case-series analysis. The risk of a cardiovascular event was increased by 25% in the first 30 days after an infection and was overall increased 18% in the 90 days after an infection-related hospitalization relative to control periods.
  
  
  CONCLUSIONS
  The first 90 days, and in particular the first 30 days, after an infection-related hospitalization is a high-risk period for cardiovascular events and may be an important timeframe for cardiovascular risk reduction, monitoring, and intervention in older patients on dialysis.
authors.affiliation: Department of Medicine, Division of Nephrology, University of California, Davis, Sacramento, CA 95817, USA. Lorien.Dalrymple@ucdmc.ucdavis.edu
authors.forename: Lorien S
authors.initials: LS
authors.lastname: Dalrymple
authors.forename: Sandra M
authors.initials: SM
authors.lastname: Mohammed
authors.forename: Yi
authors.initials: Y
authors.lastname: Mu
authors.forename: Kirsten L
authors.initials: KL
authors.lastname: Johansen
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Chertow
authors.forename: Barbara
authors.initials: B
authors.lastname: Grimes
authors.forename: George A
authors.initials: GA
authors.lastname: Kaysen
authors.forename: Danh V
authors.initials: DV
authors.lastname: Nguyen
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D003141:Communicable Diseases / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data; D006435:Renal Dialysis / Q000009:adverse effects* / Q000401:mortality; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology