Incidence of Post Operative VTE following Panniculectomy in Patients with History of COVID-19.

Abstract

Purpose: Venous thromboembolism (VTE) is a well-documented post operative complication with potentially life-threatening sequela. While the risk of VTE in plastic surgery patients is low, these devastating consequences pose a critical need for assessment of risk factors in elective operations. Recent research has elucidated that a history of COVID-19 infection may be an additional predisposing risk factor to VTE formation. Therefore, our study aims to assess the risk of VTE in panniculectomy patients with the history of COVID-19.

Methods: The TriNetX LLC. National Health Research database, which collects data from hospitals within the United States, was queried to identify patients who underwent panniculectomy in the years 2017-2020 (pre-pandemic) and 2020-2023 (post-pandemic). Mandatory testing and reporting offered a unique opportunity to capture the ICD-10 COVID diagnosis during the study period. Post-pandemic patients were studied by querying the data to look for those with a history of COVID versus those without. These cohorts were analyzed to calculate the incidence rate of VTE in the 30 day post operative period.

Results: A total cohort of 7,114 patients who underwent panniculectomy on prophylactic anticoagulation - a treatment for VTE - were identified. There were 3,015 patients in the pre-pandemic category and 4,099 patients in the post-pandemic group. Within the post-pandemic classification, there were 790 patients with a prior history of COVID and 3,309 patients without. The rate of VTE was not significantly different in the pre (3.2%) versus post (3.0%) pandemic cohorts (p=0.64). However, in the post-pandemic cohort, there was a significant difference in VTE rates between patients with (4.9%) and without (2.5%) prior history of COVID (p= 0.0002).

Conclusion: Our study showed there was no significant increase in VTE incidence after panniculectomy during the pandemic. However, in the subpopulation of patients identified with a COVID diagnosis, we observed a significantly higher rate of VTE compared to panniculectomy patients without a diagnosis of COVID. Therefore, patients with a history of COVID may be more susceptible to postoperative VTEs. Seeing as its true long-term morbidity effects are yet to be fully understood, a history of COVID should be carefully considered when determining a patient's VTE risk. This data thereby warrants further study for optimal perioperative and postoperative anticoagulation strategies.