Outcomes of Infrainguinal Bypass in Patients with Cannabis vs Opioid Use Disorder

Narayanan, Meyyammai; Alnahhal, Khaled I.; Lingutla, Ranjana; Irshad, Ali; Iafrati, Mark D.; Suarez, Luis; Kumar, Shivani; Salehi, Payam

doi:10.1016/j.avsg.2021.10.069

Cited by 6 publications

(15 citation statements)

References 26 publications

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“…A nationwide study of elective spine surgeries found an increased risk of venous thromboembolism, respiratory complications, stroke, and sepsis; a longer length of stay; and higher hospitalization costs associated with cannabis use disorder . Studies in patients undergoing vascular surgery also showed a significant association of cannabis use disorder with myocardial infarction and stroke …”

Section: Discussionmentioning

confidence: 99%

“…This database, published by the federal Agency for Healthcare Research and Quality (AHRQ), contains inpatient care data on more than 7 million hospital stays per year. Previous studies have used NIS data for perioperative outcomes research . Data before 2016 were excluded from this study because they contain older diagnostic and procedure coding from before the nationwide transition on October 1, 2015, to the current system of International Statistical Classification of Diseases and Related Health Problems, Tenth Revision ( ICD-10 ) coding.…”

Section: Methodsmentioning

confidence: 99%

“…Previous studies have used NIS data for perioperative outcomes research. [10][11][12][13][14]20 Data before 2016 were excluded from this study because they contain older diagnostic and procedure coding from before the nationwide transition on October 1, 2015, to the current system of International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) coding. Furthermore, a similar study using NIS data before 2016 was previously published.…”

Section: Setting and Data Sourcementioning

confidence: 99%

“…Covariates were selected based on clinical plausibility and previous literature on cannabis use disorder and perioperative outcomes. [9][10][11][12][13][14][15]31 A complete list of covariates is outlined in Table 1. Comorbidities were identified using Elixhauser Comorbidity Software Refined for ICD-10-CM (International Statistical Classification of Diseases, Tenth Revision, Clinical Modification), developed by the AHRQ for use with the NIS database.…”

Section: Covariatesmentioning

confidence: 99%

“…7 Data from the literature on the perioperative impact of cannabis use are conflicting. Studies in specific surgical populations have identified an association between cannabis use and increased perioperative complications, hospital length of stay, and hospitalization cost, [8][9][10][11][12][13] whereas other studies have not identified the same associations with cannabis use. [14][15][16] A large, national-level study using data before 2016 from the National Inpatient Sample (NIS) for major elective surgery did not find a significant association between cannabis use and overall surgical patient morbidity and mortality.…”

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confidence: 99%

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Cannabis Use Disorder and Perioperative Complications

2023

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ImportanceCannabis use is growing in the US and is increasingly perceived as harmless. However, the perioperative impact of cannabis use remains uncertain.ObjectiveTo assess whether cannabis use disorder is associated with increased morbidity and mortality after major elective, inpatient, noncardiac surgery.Design, Setting, and ParticipantsThis retrospective, population-based, matched cohort study used data from the National Inpatient Sample for adult patients aged 18 to 65 years who underwent major elective inpatient surgery (including cholecystectomy, colectomy, inguinal hernia repair, femoral hernia repair, mastectomy, lumpectomy, hip arthroplasty, knee arthroplasty, hysterectomy, spinal fusion, and vertebral discectomy) from January 2016 to December 2019. Data were analyzed from February to August 2022.ExposureCannabis use disorder, as defined by the presence of specific International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) diagnostic codes.Main Outcome and MeasuresThe primary composite outcome was in-hospital mortality and 7 major perioperative complications (myocardial ischemia, acute kidney injury, stroke, respiratory failure, venous thromboembolism, hospital-acquired infection, and surgical procedure–related complications) based on ICD-10 discharge diagnosis codes. Propensity score matching was performed to create a 1:1 matched cohort that was well balanced with respect to covariates, which included patient comorbidities, sociodemographic factors, and procedure type.ResultsAmong 12 422 hospitalizations, a cohort of 6211 patients with cannabis use disorder (median age, 53 years [IQR, 44-59 years]; 3498 [56.32%] male) were matched with 6211 patients without cannabis use disorder for analysis. Cannabis use disorder was associated with an increased risk of perioperative morbidity and mortality compared with hospitalizations without cannabis use disorder in adjusted analysis (adjusted odds ratio, 1.19; 95% CI, 1.04-1.37; P = .01). The outcome occurred more frequently in the group with cannabis use disorder (480 [7.73%]) compared with the unexposed group (408 [6.57%]).Conclusions and RelevanceIn this cohort study, cannabis use disorder was associated with a modest increased risk of perioperative morbidity and mortality after major elective, inpatient, noncardiac surgery. In the context of increasing cannabis use rates, our findings support preoperative screening for cannabis use disorder as a component of perioperative risk stratification. However, further research is needed to quantify the perioperative impact of cannabis use by route and dosage and to inform recommendations for preoperative cannabis cessation.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Setting and Data Sourcementioning

confidence: 99%

Section: Covariatesmentioning

confidence: 99%

mentioning

confidence: 99%

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Cannabis Use Disorder and Perioperative Complications

2023

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Addressing Psychosocial Care Needs in Women with Peripheral Artery Disease

Mubarak,

Cleman,

Romain

et al. 2024

Curr Cardiol Rep

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Marijuana and Vascular Disease: A Review

Ye,

Hines

2024

Cardiology in Review

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Marijuana use is common and increasing due to decriminalization, legalization, and expansion of medical use. As a result, the proportion of vascular patients with marijuana is also expected to increase, raising questions if cannabis use affects the incidence and outcomes of vascular disease. Active ingredients of cannabis have been shown to interact with receptors found on vascular endothelium, promoting oxidative stress and endothelial dysfunction. However, current clinical studies have yet to demonstrate a relationship between marijuana use and atherosclerosis. Nonetheless, cannabis arteritis is a rare condition where cannabis is hypothesized to induce vascular inflammation. Future research with high-quality studies is needed to clarify the impact of marijuana use on vascular diseases.

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Outcomes of Infrainguinal Bypass in Patients with Cannabis vs Opioid Use Disorder

Cited by 6 publications

References 26 publications

Cannabis Use Disorder and Perioperative Complications

Cannabis Use Disorder and Perioperative Complications

Addressing Psychosocial Care Needs in Women with Peripheral Artery Disease

Marijuana and Vascular Disease: A Review

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