The Impact Of SARS-CoV-2 Vaccination On Post Operative Outcomes In 818 Microsurgery Patients: A Multicenter Analysis
Susan M. Taghioff, BS1, Benjamin R. Slavin, M.D.1, Manish Narasimman, B.A.1, Minji Kim, B.S.1, Tripp Holton, M.D.2, Devinder Singh, M.D.1.
1University of Miami Miller School of Medicine, Division of Plastic & Reconstructive Surgery, Miami, FL, USA, 2Anne Arundel Medical Center/Luminis Health, Annapolis, MD, USA.
The healthcare industry's efforts to immunize the global community against SARS-CoV-2 are unprecedented. Given vaccine fast-tracking, its medical implications remain largely unknown in many populations. This study aims to analyze post-operative outcomes in SARS-CoV-2-vaccinated microsurgery patients to ascertain its potential protective effects using a federated electronic medical record network (TriNetX Inc, Cambridge,MA).
After screening 70 million de-identified records, 16,799 microsurgery patients meeting criteria were allocated into two cohorts using medical coding. Cohort One received SARS-CoV-2-vaccination prior to undergoing microsurgery whereas Cohort Two did not. Two equal sized cohorts, totaling 818 patients were created following propensity score matching for characteristics including: age, race/ethnicity, smoking, hypertension, heart disease, diabetes, obesity, chronic obstructive pulmonary disease, and history of SARS-CoV-2 exposure. Postoperative outcomes within 30,60, and 90-days of microsurgery were analyzed.
RESULTSPatients who were SARS-CoV-2-immunized experienced significantly fewer(p<0.01) surgical site infections (Absolute Risk Reduction(ARR)[95%CI])=(3.79-5.36%[0.84-8.54]), ICU admission(9.47-9.82%[5.45-13.88]), infections(7.68-9.92%[3.15-14.64]), and hospitalizations(28.48-32.57%[20.99-40.13]) within 30,60, and 90-days of microsurgery. Vaccinated patients also experienced significantly less flap failure(2.49%[0.97-4.02] and death(2.46%[0.96-3.97]) within 30 and 60-days post-operatively(Figure 1).
Our analysis explores the potential protective effect of SARS-CoV-2-vaccination in microsurgical patients. Limitations include the retrospective nature and reliance on accuracy of medical coding of our study. Future prospective randomized control trials are warranted to better understand if in fact pre-operative SARS-CoV-2- vaccination has the potential to protect against post-operative microsurgery outcomes.
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