Wang Kevin C, Wang Sophia, Serna Juan, Su Favian, Halvorson Ryan T, Lansdown Drew A, Ma C Benjamin, Zhang Alan L
Department of Orthopedic Surgery, University of California San Francisco, San Francisco, California, USA.
Department of Orthopedic Surgery, University of California San Francisco, San Francisco, California, USA.
Arthroscopy. 2025 Aug;41(8):2919-2926. doi: 10.1016/j.arthro.2024.12.013. Epub 2024 Dec 19.
To determine if preoperative infection with COVID-19 increased risk for postoperative venous thromboembolism (VTE) in patients undergoing arthroscopic knee surgery.
PearlDiver Mariner 165 database was queried for patients undergoing knee arthroscopy between 2010 and October 2022. Patients were categorized by history of COVID-19 diagnosis and timing in relation to surgery. Multivariate logistic regression was performed to isolate the effect of COVID-19 diagnosis on postoperative VTE rates. Covariates included age, obesity, smoking, oral contraceptive pill use, hypertension, coronary artery disease, congestive heart failure, malignancy, renal disease, and diabetes.
A total of 954,294 patients met inclusion criteria, and 7,637 patients experienced VTE, including deep vein thrombosis (n = 5,830, 0.61%) and pulmonary embolism (n = 2,790, 0.29%). Patients with a COVID-19 diagnosis before surgery (7,858) had an overall higher incidence of VTE (1.72%) compared to patients without a preoperative COVID-19 diagnosis (0.81%) (P < .001). There was no difference in VTE incidence among patients with a preoperative COVID-19 diagnosis undergoing knee arthroscopy in the pre- and post-COVID-19 vaccination eras (odds ratio, 0.82; 95% CI, 0.51-1.31; P = .48). Multivariate regression accounting for covariates showed that patients with a preoperative COVID-19 diagnosis within 6 weeks before arthroscopy had significantly increased odds of experiencing postoperative VTE (odds ratio, 1.68; 95% CI, 1.09-2.45; P = .012). There was no significant difference in VTE risk among patients with a preoperative COVID-19 diagnosis between 6 and 12 weeks before arthroscopy and more than 12 weeks before arthroscopy compared to those with no prior COVID-19 diagnosis.
COVID-19 diagnosis within 6 weeks preceding arthroscopic knee surgery leads to a significantly higher risk for postoperative VTE.
Level III, retrospective case control study.
确定接受关节镜膝关节手术的患者术前感染新型冠状病毒肺炎（COVID-19）是否会增加术后静脉血栓栓塞（VTE）的风险。
在PearlDiver Mariner 165数据库中查询2010年至2022年10月期间接受膝关节镜检查的患者。根据COVID-19诊断史和与手术的时间关系对患者进行分类。进行多因素逻辑回归分析以确定COVID-19诊断对术后VTE发生率的影响。协变量包括年龄、肥胖、吸烟、口服避孕药使用、高血压、冠状动脉疾病、充血性心力衰竭、恶性肿瘤、肾脏疾病和糖尿病。
共有954,294例患者符合纳入标准，7,637例患者发生VTE，包括深静脉血栓形成（n = 5,830，0.61%）和肺栓塞（n = 2,790，0.29%）。术前诊断为COVID-19的患者（7,858例）的VTE总体发生率（1.72%）高于术前未诊断为COVID-19的患者（0.81%）（P <.001）。在COVID-19疫苗接种前和接种后时代，接受膝关节镜检查且术前诊断为COVID-19的患者之间的VTE发生率没有差异（比值比，0.82；95%可信区间，0.51-1.31；P =.48）。考虑协变量的多因素回归分析显示，在关节镜检查前6周内术前诊断为COVID-19的患者术后发生VTE的几率显著增加（比值比，1.68；95%可信区间，1.09-2.45；P =.012）。与术前未诊断为COVID-19的患者相比，在关节镜检查前6至12周和超过12周术前诊断为COVID-19的患者之间的VTE风险没有显著差异。
关节镜膝关节手术前6周内诊断为COVID-19会导致术后VTE风险显著升高。
III级，回顾性病例对照研究。
