Alejandro M Holle, Nathan C Beckett, Jose M Iturregui, Jack M Haglin, Todd A Kile
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引用次数: 0
Abstract
Background: The purpose of this study was to investigate the association between cannabis use and postoperative complications following ankle and hindfoot arthrodesis.
Methods: A retrospective cohort study using a large national insurance database from 2010 to 2022 was conducted. All patients who underwent ankle or hindfoot arthrodesis with at least 2 years' follow-up were included. Patients were divided into 4 groups: cannabis-only users, tobacco-only users, cannabis and tobacco users, and nonuser controls. Groups were matched 1:4 with nonuser controls based on demographic variables and comorbidities. Also, both cannabis and tobacco users were matched 1:4 with tobacco-only users based on demographics and comorbidities. Medical complications within 90 days of surgery and surgery-specific complications within 2 years were compared between groups with multivariable logistic regressions.
Results: Compared with nonuser controls, cannabis users only were not at increased risk of 90-day medical complications or 2-year surgical complications. Tobacco use alone was associated with increased risk of postoperative admission (OR 1.32, 95% CI 1.21-1.43) and emergency department (ED) utilization (OR 1.57, 95% CI 1.48-1.66) within 90 days as well as infection (OR 1.24, 95% CI 1.18-1.30), hardware removal (OR 1.12, 95% CI 1.07-1.18), nonunion (OR 1.33, 95% CI 1.27-1.40), and wound dehiscence (OR 1.38, 95% CI 1.27-1.49) within 2 years of surgery compared with nonuser controls. Compared with tobacco-only use, combined cannabis and tobacco use was associated with increased risk of ED visits within 90 days (OR 1.45, 95% CI 1.30-1.62) and nonunion within 2 years of surgery (OR 1.19, 95% CI 1.05-1.35).
Conclusion: These findings suggest that although cannabis use alone was not associated with a higher risk of postoperative complications, its concurrent use with tobacco was linked to greater rates of adverse outcomes.
Level of evidence: Level III, retrospective case control study.
背景：本研究的目的是调查大麻使用与踝关节和后足关节融合术术后并发症之间的关系。方法：采用2010 - 2022年全国大型保险数据库进行回顾性队列研究。所有接受踝关节或后足关节融合术的患者至少随访2年。患者分为4组：纯大麻使用者、纯烟草使用者、大麻和烟草使用者以及非使用者对照组。根据人口统计学变量和合并症，各组与非用户对照组1:4匹配。此外，根据人口统计和合并症，大麻和烟草使用者与仅烟草使用者按1:4匹配。采用多变量logistic回归对两组手术90天内的医学并发症和2年内的手术特异性并发症进行比较。结果：与不使用大麻的对照组相比，只有大麻使用者的90天医疗并发症或2年手术并发症的风险没有增加。单独吸烟与术后入院（OR 1.32, 95% CI 1.21-1.43）和90天内急诊（ED）使用率（OR 1.57, 95% CI 1.48-1.66）以及手术2年内感染（OR 1.24, 95% CI 1.18-1.30）、硬体取出（OR 1.12, 95% CI 1.07-1.18）、骨不连（OR 1.33, 95% CI 1.27-1.40）和伤口裂开（OR 1.38, 95% CI 1.27-1.49）的风险增加相关。与仅使用烟草相比，大麻和烟草联合使用与90天内ED就诊风险增加（OR 1.45, 95% CI 1.30-1.62）和2年内手术不愈合风险增加（OR 1.19, 95% CI 1.05-1.35）相关。结论：这些发现表明，尽管单独使用大麻与术后并发症的高风险无关，但同时使用大麻与烟草的不良后果发生率更高。证据等级：III级，回顾性病例对照研究。
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