TY - JOUR
T1 - Prevalence of cannabis use disorder and perioperative outcomes in adult colectomy patients
T2 - A propensity score-matched analysis
AU - Lo, Brian D.
AU - Chen, Sophia Y.
AU - Stem, Miloslawa
AU - Papanikolaou, Angelos
AU - Gabre-Kidan, Alodia
AU - Safar, Bashar
AU - Efron, Jonathan E.
AU - Atallah, Chady
N1 - Publisher Copyright:
© 2024 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).
PY - 2024/3
Y1 - 2024/3
N2 - Background: The decriminalization of cannabis across the United States has led to an increased number of patients reporting cannabis use prior to surgery. However, it is unknown whether preoperative cannabis use disorder (CUD) increases the risk of postoperative complications among adult colectomy patients. Methods: Adult patients undergoing an elective colectomy were retrospectively analyzed from the National Inpatient Sample database (2004–2018). To control for potential confounders, patients with CUD, defined using ICD-9/10 codes, were propensity score matched to patients without CUD in a 1:1 ratio. The association between preoperative CUD and composite morbidity, the primary outcome of interest, was assessed. Subgroup analyses were performed after stratification by age (≥50 years). Results: Among 432,018 adult colectomy patients, 816 (0.19%) reported preoperative CUD. The prevalence of CUD increased nearly three-fold during the study period from 0.8/1000 patients in 2004 to 2.0/1000 patients in 2018 (P-trend<0.001). After propensity score matching, patients with CUD exhibited similar rates of composite morbidity (140 of 816; 17.2%) as those without CUD (151 of 816; 18.5%) (p = 0.477). Patients with CUD also had similar anastomotic leak rates (CUD: 5.64% vs. No CUD: 6.25%; p = 0.601), hospital lengths of stay (CUD: 5 days, IQR 4–7 vs. No CUD: 5 days, IQR 4–7) (p = 0.415), and hospital charges as those without CUD. Similar findings were seen among patients aged ≥50 years in the subgroup analysis. Conclusions: Though the prevalence of CUD has increased drastically over the past 15 years, preoperative CUD was not associated with an increased risk of composite morbidity among adult patients undergoing an elective colectomy.
AB - Background: The decriminalization of cannabis across the United States has led to an increased number of patients reporting cannabis use prior to surgery. However, it is unknown whether preoperative cannabis use disorder (CUD) increases the risk of postoperative complications among adult colectomy patients. Methods: Adult patients undergoing an elective colectomy were retrospectively analyzed from the National Inpatient Sample database (2004–2018). To control for potential confounders, patients with CUD, defined using ICD-9/10 codes, were propensity score matched to patients without CUD in a 1:1 ratio. The association between preoperative CUD and composite morbidity, the primary outcome of interest, was assessed. Subgroup analyses were performed after stratification by age (≥50 years). Results: Among 432,018 adult colectomy patients, 816 (0.19%) reported preoperative CUD. The prevalence of CUD increased nearly three-fold during the study period from 0.8/1000 patients in 2004 to 2.0/1000 patients in 2018 (P-trend<0.001). After propensity score matching, patients with CUD exhibited similar rates of composite morbidity (140 of 816; 17.2%) as those without CUD (151 of 816; 18.5%) (p = 0.477). Patients with CUD also had similar anastomotic leak rates (CUD: 5.64% vs. No CUD: 6.25%; p = 0.601), hospital lengths of stay (CUD: 5 days, IQR 4–7 vs. No CUD: 5 days, IQR 4–7) (p = 0.415), and hospital charges as those without CUD. Similar findings were seen among patients aged ≥50 years in the subgroup analysis. Conclusions: Though the prevalence of CUD has increased drastically over the past 15 years, preoperative CUD was not associated with an increased risk of composite morbidity among adult patients undergoing an elective colectomy.
KW - cannabis use disorder
KW - colectomy
KW - colorectal surgery
KW - marijuana
KW - morbidity
KW - outcomes
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U2 - 10.1002/wjs.12085
DO - 10.1002/wjs.12085
M3 - Article
C2 - 38342773
AN - SCOPUS:85187206166
SN - 0364-2313
VL - 48
SP - 701
EP - 712
JO - World Journal of Surgery
JF - World Journal of Surgery
IS - 3
ER -