Preoperative COVID-19 Vaccination is Associated with Decreased Perioperative Mortality after Major Vascular Surgery.


Journal

Annals of surgery
ISSN: 1528-1140
Titre abrégé: Ann Surg
Pays: United States
ID NLM: 0372354

Informations de publication

Date de publication:
10 May 2024
Historique:
medline: 10 5 2024
pubmed: 10 5 2024
entrez: 10 5 2024
Statut: aheadofprint

Résumé

The objective of this study was to examine the effect of corona virus 2019 (COVID-19) vaccination on perioperative outcomes after major vascular surgery. COVID-19 vaccination is associated with decreased mortality in patients undergoing various surgical procedures. However, the effect of vaccination on perioperative mortality after major vascular surgery is unknown. This is a multicenter retrospective study of patients who underwent major vascular surgery between December 2021 through August 2023. The primary outcome was all-cause mortality within 30 days of index operation or prior to hospital discharge. Multivariable models were used to examine the association between vaccination status and the primary outcome. Of the total 85,424 patients included, 19161 (22.4%) were unvaccinated. Unvaccinated patients were younger compared to vaccinated patients (mean age 68.44 +/- 10.37 y vs 72.11 +/- 9.20 y, P<0.001) and less likely to have comorbid conditions, including hypertension, congestive heart failure, chronic obstructive pulmonary disease, and dialysis. After risk factor adjustment, vaccination was associated with decreased mortality (OR 0.7, 95% CI 0.62 - 0.81, P<0.0001). Stratification by procedure type demonstrated that vaccinated patients had decreased odds of mortality after open AAA (OR 0.6, 95% CI 0.42-0.97, P=0.03), EVAR (OR 0.6, 95% CI 0.43-0.83, p 0.002), CAS (OR 0.7, 95% CI 0.51-0.88, P=0.004) and infra-inguinal lower extremity bypass (OR 0.7, 95% CI 0.48-0.96, P=0.03). COVID-19 vaccination is associated with reduced perioperative mortality in patients undergoing vascular surgery. This association is most pronounced for patients undergoing aortic aneurysm repair, carotid stenting and infrainguinal bypass.

Sections du résumé

OBJECTIVE OBJECTIVE
The objective of this study was to examine the effect of corona virus 2019 (COVID-19) vaccination on perioperative outcomes after major vascular surgery.
BACKGROUND DATA BACKGROUND
COVID-19 vaccination is associated with decreased mortality in patients undergoing various surgical procedures. However, the effect of vaccination on perioperative mortality after major vascular surgery is unknown.
METHODS METHODS
This is a multicenter retrospective study of patients who underwent major vascular surgery between December 2021 through August 2023. The primary outcome was all-cause mortality within 30 days of index operation or prior to hospital discharge. Multivariable models were used to examine the association between vaccination status and the primary outcome.
RESULTS RESULTS
Of the total 85,424 patients included, 19161 (22.4%) were unvaccinated. Unvaccinated patients were younger compared to vaccinated patients (mean age 68.44 +/- 10.37 y vs 72.11 +/- 9.20 y, P<0.001) and less likely to have comorbid conditions, including hypertension, congestive heart failure, chronic obstructive pulmonary disease, and dialysis. After risk factor adjustment, vaccination was associated with decreased mortality (OR 0.7, 95% CI 0.62 - 0.81, P<0.0001). Stratification by procedure type demonstrated that vaccinated patients had decreased odds of mortality after open AAA (OR 0.6, 95% CI 0.42-0.97, P=0.03), EVAR (OR 0.6, 95% CI 0.43-0.83, p 0.002), CAS (OR 0.7, 95% CI 0.51-0.88, P=0.004) and infra-inguinal lower extremity bypass (OR 0.7, 95% CI 0.48-0.96, P=0.03).
CONCLUSIONS CONCLUSIONS
COVID-19 vaccination is associated with reduced perioperative mortality in patients undergoing vascular surgery. This association is most pronounced for patients undergoing aortic aneurysm repair, carotid stenting and infrainguinal bypass.

Identifiants

pubmed: 38726660
doi: 10.1097/SLA.0000000000006341
pii: 00000658-990000000-00880
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

The authors declare no conflict of interest. This study did not receive funding.

Auteurs

Molly Ratner (M)

Division of Vascular and Endovascular Surgery, Department of Surgery, New York University Langone Medical Center, New York, NY.

Karan Garg (K)

Division of Vascular and Endovascular Surgery, Department of Surgery, New York University Langone Medical Center, New York, NY.

Heepeel Chang (H)

Division of Vascular Surgery, Department of Surgery, Westchester Medical Center, Valhalla, NY.

Anjali Nigalaye (A)

Division of Hospitalist Medicine, Department of Medicine, Mount Sinai Beth Israel Hospital, New York, NY.

Steven Medvedosky (S)

Division of Vascular and Endovascular Surgery, Department of Surgery, New York University Langone Medical Center, New York, NY.

Glenn Jacobowitz (G)

Division of Vascular and Endovascular Surgery, Department of Surgery, New York University Langone Medical Center, New York, NY.

Jeffrey J Siracuse (JJ)

Division of Vascular and Endovascular Surgery, Department of Surgery, Boston Medical Center, Boston, Massachusetts.

Virendra Patel (V)

Division of Vascular and Endovascular Interventions, Department of Surgery, New York Presbyterian- Columbia University Irving Medical Center, New York, NY.

Marc Schermerhorn (M)

Division of Vascular and Endovascular Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Charles DiMaggio (C)

Division of Vascular and Endovascular Surgery, Department of Surgery, New York University Langone Medical Center, New York, NY.

Caron B Rockman (CB)

Division of Vascular and Endovascular Surgery, Department of Surgery, New York University Langone Medical Center, New York, NY.

Classifications MeSH