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Associations Between Prior Covid-19 Infection And Venous Thromboembolism Following Common Plastic Surgery Operations
Max Silverstein, MD1, Jennifer Shah, BA, BS
1, Priscila Cevallos, BS
2, Farrah Liu, MD
1, Clifford Sheckter, MD
1, Rahim Nazerali, MD, MHS
1;
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 Merative
TM 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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