Cannabis Abuse and Peri-operative Complications Following Inpatient Spine Surgery in the United States. (16th November 2020)

• Record Type: Journal Article
• Authors: Chiu, Ryan G; Siddiqui, Neha; Patel, Saavan; Nunna, Ravi S; Mehta, Ankit I
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_772
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: Cannabis is the most popular illicit drug in the United States, and its use has been increasing in light of state efforts to decriminalize and legalize its use for both medical and recreational purposes. Its legal status has long precluded extensive research into its adverse effects, and to date, little research has been done on the sequelae of cannabis on surgical patients, particularly in spine surgery. METHODS: The 2012–2015 Nationwide Inpatient Sample was queried for all patients undergoing common elective spine surgery procedures. These patients were then grouped by the presence of concurrent diagnosis of cannabis use disorder, and compared with respect to various peri- and postoperative complications, all-cause mortality, discharge disposition, length of stay, and hospitalization costs. Propensity score matching was utilized to control for potential baseline confounders. RESULTS: A total of 423, 978 patients met inclusion/exclusion criteria, 2, 393 (0.56%) of whom had cannabis use disorder. After controlling for baseline characteristics, these patients had higher rates of inpatient mortality (odds ratio [OR] 6.3; 95% confidence interval [CI] 1.1 to 159.4; P = .034), perioperative myocardial infarction (OR 6.3; 95% CI 1.1 to 159.4; P = .034), respiratory complications (OR 1.7; 95% CI 1.2 to 2.4; P = .001), and non-routine discharge, as well as increased lengths of stay (7.1 vs. 5.6 days, P < .001) and hospitalization charges ($137, 631.30 vs. $123, 590.10, P < .001). CONCLUSION: Chronic cannabis use appears to be associated with increased perioperative morbidity and mortality among spine surgery patients. Physicians should ensure that a thorough preoperative drug use history is taken, and that affected patients be adequately informed of associated risks.