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Augmenting Large Language Models via Vector Embeddings to Improve Domain-Specific Responsiveness

Large language models (LLMs) have emerged as a popular resource for generating information relevant to a user query. Such models are created through a ...

Medical College of Wisconsin

Vaccination Against SARS-CoV-2 Decreases Risk of Adverse Events in Patients who Develop COVID-19 Following Cancer Surgery.

Reply to: COVID-19 Vaccination in Patients who Develop COVID-19 After Cancer Surgery: Correspondence by Mungmunpuntipantip and Wiwanitkit.

As the coronavirus disease 2019 (COVID-19) pandemic progresses to an endemic phase, a greater number of patients with a history of COVID-19 will undergo surgery. Major adverse cardiovascular and cerebrovascular events (MACE) are the primary contributors to postoperative morbidity and mortality; however, studies assessing the relationship between a previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and postoperative MACE outcomes are limited. Here, we analyzed retrospective data from 457,804 patients within the N3C Data Enclave, the largest national, multi-institutional data set on COVID-19 in the United States. However, 7.4% of patients had a history of COVID-19 before surgery. When comorbidities, age, race, and risk of surgery were controlled, patients with preoperative COVID-19 had an increased risk for 30-day postoperative MACE. MACE risk was influenced by an interplay between COVID-19 disease severity and time between surgery and infection; in those with mild disease, MACE risk was not increased even among those undergoing surgery within 4 wk following infection. In those with moderate disease, risk for postoperative MACE was mitigated 8 wk after infection, whereas patients with severe disease continued to have elevated postoperative MACE risk even after waiting for 8 wk. Being fully vaccinated decreased the risk for postoperative MACE in both patients with no history of COVID-19 and in those with breakthrough COVID-19 infection. Together, our results suggest that a thorough assessment of the severity, vaccination status, and timing of SARS-CoV-2 infection must be a mandatory part of perioperative stratification. With an increasing proportion of patients undergoing surgery with a prior history of COVID-19, it is crucial to understand the impact of SARS-CoV-2 infection on postoperative cardiovascular/cerebrovascular risk. Our work assesses a large, national, multi-institutional cohort of patients to highlight that COVID-19 infection increases risk for postoperative major adverse cardiovascular and cerebrovascular events (MACE). MACE risk is influenced by an interplay between disease severity and time between infection and surgery, and full vaccination reduces the risk for 30-day postoperative MACE. These results highlight the importance of stratifying time-to-surgery guidelines based on disease severity.

Preoperative SARS-CoV-2 infection increases risk of early postoperative cardiovascular complications following noncardiac surgery.

Lessons in a Loss: A Journey Through Friendship, Cancer, and Medical School.

To determine the association between severity of prior history of SARS-CoV-2 infection and postoperative outcomes following major elective inpatient surgery.

Severity of Prior COVID-19 Infection is Associated with Postoperative Outcomes Following Major Inpatient Surgery.

Bridging the Gap: Trainee Reflections About Navigating Otherness in Academic Surgery.

To determine how the severity of prior history (Hx) of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection influences postoperative outcomes after major elective inpatient surgery.

Severity of Prior Coronavirus Disease 2019 is Associated With Postoperative Outcomes After Major Inpatient Surgery.

Characterizing the impact of SARS-CoV-2 reinfection on surgical outcomes.

As the COVID-19 pandemic shifts to an endemic phase, an increasing proportion of patients with cancer and a preoperative history of COVID-19 will require surgery. This study aimed to assess the influence of preoperative COVID-19 on postoperative risk for major adverse cardiovascular and cerebrovascular events (MACEs) among those undergoing surgical cancer resection. Secondary objectives included determining optimal time-to-surgery guidelines based on COVID-19 severity and discerning the influence of vaccination status on MACE risk.

Risk of Early Postoperative Cardiovascular and Cerebrovascular Complication in Patients with Preoperative COVID-19 Undergoing Cancer Surgery.

The COVID-19 pandemic has significantly influenced surgical practices, with SARS-CoV-2 variants presenting unique pathologic profiles and potential impacts on perioperative outcomes. This study explores associations between Alpha, Delta, and Omicron variants of SARS-CoV-2 and surgical outcomes.

From Alpha to Omicron and Beyond: Associations Between SARS-CoV-2 Variants and Surgical Outcomes.

The association between preoperative wearable device step counts and surgical outcomes has not been examined using commercial devices linked to electronic health records (EHR). This study measured the association between daily preoperative step counts and postoperative complications.

Article	Year
Vaccination Against SARS-CoV-2 Decreases Risk of Adverse Events in Patients who Develop COVID-19 Following Cancer Surgery. Annals of surgical oncology\| PubMed ID: 36479662	2023
Reply to: COVID-19 Vaccination in Patients who Develop COVID-19 After Cancer Surgery: Correspondence by Mungmunpuntipantip and Wiwanitkit. Annals of surgical oncology\| PubMed ID: 36707483	2023
Preoperative SARS-CoV-2 infection increases risk of early postoperative cardiovascular complications following noncardiac surgery. American journal of physiology. Heart and circulatory physiology\| PubMed ID: 36930659	2023
Lessons in a Loss: A Journey Through Friendship, Cancer, and Medical School. WMJ : official publication of the State Medical Society of Wisconsin\| PubMed ID: 36940113	2023
Severity of Prior COVID-19 Infection is Associated with Postoperative Outcomes Following Major Inpatient Surgery. medRxiv : the preprint server for health sciences\| PubMed ID: 37131614	2023
Bridging the Gap: Trainee Reflections About Navigating Otherness in Academic Surgery. The Journal of surgical research\| PubMed ID: 37217382	2023
Severity of Prior Coronavirus Disease 2019 is Associated With Postoperative Outcomes After Major Inpatient Surgery. Annals of surgery\| PubMed ID: 37476995	2023
Characterizing the impact of SARS-CoV-2 reinfection on surgical outcomes. The British journal of surgery\| PubMed ID: 38215236	2024
Risk of Early Postoperative Cardiovascular and Cerebrovascular Complication in Patients with Preoperative COVID-19 Undergoing Cancer Surgery. Journal of the American College of Surgeons\| PubMed ID: 38348959	2024
From Alpha to Omicron and Beyond: Associations Between SARS-CoV-2 Variants and Surgical Outcomes. The Journal of surgical research\| PubMed ID: 38917576	2024
Association of Daily Step Count and Postoperative Complication among All of Us Research Participants. Journal of the American College of Surgeons\| PubMed ID: 38920308	2024

Nathaniel B. Verhagen

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