Impact of cannabis consumption on perioperative outcomes in patients undergoing hepatobiliary and pancreatic surgery: a nationwide analysis

Abstract

Background

There is paucity of high-quality data on the effect of cannabis consumption on perioperative outcomes after hepatobiliary and pancreatic (HPB) surgery.

Methods

Data from the Nationwide Inpatient Sample (2016–2020) were used. In-hospital complications, length-of-stay and hospitalisation charges were compared among patients undergoing HPB surgery.

Results

We identified 191,315 patients, of which 1705 (0.89 %) were cannabis consumers. Cannabis consumers were more likely to be male (67.5 % vs 50.2 %), younger, and Black (22.6 % vs 11.0); p < 0.001 for all.

Multivariate analysis demonstrated a significantly lower risk of pneumonia (OR 0.54, 95 % CI 0.29–0.99) among cannabis consumers. There was no significant difference in risk of in-hospital mortality (OR 0.64, 95 % CI 0.31–1.30), acute kidney injury, hemodialysis, blood transfusion, vasopressor use, invasive and non-invasive mechanical ventilation, venous thromboembolism, portal vein thrombosis, intraabdominal abscess, peritonitis, surgical site infection, post-procedure haemorrhage/hematoma, wound dehiscence, liver failure, or sudden cardiac arrest.

There was no significant difference in length-of-stay (mean 10.99 vs 9.69 days; p = 0.348) or hospitalisation costs ($49,444 vs $43,661; p = 0.109).

Conclusion

There is no significant difference in major perioperative complications after HPB surgery among patients with cannabis use disorder. Further, there is no significant difference in health services utilisation among consumers versus non-consumers.