Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Division of Plastic & Reconstructive Surgery, Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA; Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
J Plast Reconstr Aesthet Surg. 2024 Jul;94:198-209. doi: 10.1016/j.bjps.2024.04.013. Epub 2024 Apr 20.
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). Whereas some multispecialty 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.
The Merative™ MarketScan® Research Databases were used to identify female 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 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.
Twenty-four thousand two hundred and twenty-eight patients met inclusion criteria. Mean age at time of surgery was 44 years. Six percent carried a preoperative COVID-19 diagnosis, and postoperative VTE occurred in 1.3%. In a propensity-score-matched analysis of 2754 patients, COVID-19 did not significantly correlate with incidence of postoperative VTE (P = 0.463). Compared with a matched prepandemic cohort (14,151 patients), the incidence of VTE did not increase following any of the four studied procedures during the COVID-19 pandemic.
This analysis of a 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.
SARS-CoV-2（COVID-19）感染已被描述为全身性高凝状态的原因，也是静脉血栓栓塞（VTE）发展的危险因素。虽然一些多学科研究提出了 COVID-19 与术后血栓形成之间的联系，但其他单学科研究并未发现这种关联。我们利用一个大型国家数据库来确定 COVID-19 感染是否与常见整形手术术后 VTE 的发生有关。
利用 Merative™ MarketScan® Research 数据库，确定了 2020 年至 2021 年间进行腹部腹带成形术、乳房缩小术、自体乳房重建术或植入物乳房重建术的女性患者。使用国际疾病分类，第十版（ICD-10）代码来识别术前诊断为 COVID-19 的患者和术后 90 天内发生 VTE 的患者。使用倾向评分匹配和多变量逻辑回归来确定 COVID-19 与术后 VTE 之间是否存在任何独立关联。
共有 24228 名患者符合纳入标准。手术时的平均年龄为 44 岁。6%的患者术前有 COVID-19 诊断，术后 VTE 发生率为 1.3%。在 2754 名患者的倾向评分匹配分析中，COVID-19 与术后 VTE 的发生率无显著相关性（P=0.463）。与匹配的大流行前队列（14151 名患者）相比，在 COVID-19 大流行期间，四种研究手术中没有任何一种手术后 VTE 的发生率增加。
这项对国家保险索赔数据库的分析结果表明，在四种常见整形手术术后 90 天内，已解决的 COVID-19 感染与 VTE 之间没有联系。
