American Association of Plastic Surgeons

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Associations Between Prior Covid-19 Infection And Venous Thromboembolism Following Common Plastic Surgery Operations
Max Silverstein, MD1, Jennifer Shah, BA, BS1, Priscila Cevallos, BS2, Farrah Liu, MD1, Clifford Sheckter, MD1, Rahim Nazerali, MD, MHS1;
1Stanford University School of Medicine, Palo Alto, CA, USA, 2Geisel School of Medicine at Dartmouth, Hanover, NH, USA

PURPOSE:SARS-CoV-2 (COVID-19) infection has been described as a cause of systemic hypercoagulability and a risk factor for the development of venous thromboembolism (VTE). While some multi-specialty studies have proposed a link between COVID-19 and postoperative thrombosis, other, single-specialty studies have found no such association. We utilized a large, national database to determine whether prior COVID-19 infection was associated with the incidence of VTE following common plastic surgery operations.
METHODS: The MerativeTM MarketScan Research Databases were used to identify patients who underwent index abdominal panniculectomy, breast reduction, autologous breast reconstruction or implant-based breast reconstruction procedures between 2020 and 2021. International Classification of Disease, tenth edition (ICD-10) codes were used to identify patients who were diagnosed with COVID-19 preoperatively and those who experienced a VTE in the 90 days postoperatively. Propensity score matching and multivariable logistic regression were used to determine any independent association between COVID-19 and postoperative VTE.
RESULTS: 24,228 patients met inclusion criteria. Mean age at time of surgery was 44 years. 6.0% carried a preoperative COVID-19 diagnosis, and postoperative VTE occurred in 1.3%. In a propensity-score-matched analysis, COVID-19 did not significantly correlate with incidence of postoperative VTE (p = 0.463). Compared to a matched pre-pandemic cohort, the incidence of VTE did not increase following any of the four studied procedures during the COVID-19 pandemic.
CONCLUSION: This analysis of a large, national insurance claims database provides evidence against a link between resolved COVID-19 infection and VTE within 90 days of four common plastic surgery operations.
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