Weeding Out the Problem: Associations of Cannabis and Tobacco Use with Complications of Surgical Fixation of Metacarpal Fracture.

IF 0.5 Q4 SURGERY
Arman Kishan, Victoria E Bergstein, Ansh Kishan, Pawel Jankowski, Sami H Tuffaha, Dawn M Laporte
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引用次数: 0

Abstract

Background: Given the increasing prevalence of cannabis use, it is critical to understand its association with postoperative complications. We investigated association between cannabis use and complications after metacarpal fracture fixation. Methods: We identified 80,787 patients from a US insurance claims database who underwent metacarpal fracture fixation from 2010 to 2022; 5,043 (6.7%) had diagnosed cannabis use disorder, dependence or addiction. Cannabis users were compared with patients with history of tobacco use and those with no history of using either substance ('control group'). Propensity matching was used to control for age, sex and Charlson Comorbidity Index (CCI) value. Demographic and comorbidity profiles, 90-day medical complications and 6-month surgical complications were compared using chi-squared tests (α = 0.05). Results: Compared with the control group, cannabis users had a higher incidence of acute kidney injury, cardiac arrest, deep venous thrombosis, hypoglycemia, myocardial infarction, pneumonia, sepsis, stroke and urinary tract infection (all, p < 0.01) within 90 days after surgery. After matching the cannabis and control groups, the cannabis group had a higher incidence of nerve injury (p < 0.01), fracture nonunion (p = 0.04) and fracture malunion (p = 0.002). Compared with tobacco users, cannabis users had a lower incidence of pneumonia (p = 0.002), urinary tract infection (p < 0.01) and hypoglycemia (p = 0.03) within 90 days. Conclusions: Compared with patients who had no history of drug use, cannabis users had a higher incidence of several medical and surgical complications. Compared with tobacco users, cannabis users had a lower incidence of some medical complications. These differences underscore the need for tailored perioperative care strategies for cannabis users. Level of Evidence: Level III (Therapeutic).

消除问题:大麻和烟草使用与掌骨骨折手术固定并发症的关系。
背景:鉴于大麻使用的日益普遍,了解其与术后并发症的关系至关重要。我们调查了大麻使用与掌骨骨折固定后并发症之间的关系。方法:我们从美国保险索赔数据库中选取了80787例2010年至2022年间接受掌骨骨折固定的患者;5043人(6.7%)被诊断为大麻使用障碍、依赖或成瘾。大麻使用者与有烟草使用史的患者和没有使用任何一种物质的患者(“对照组”)进行比较。采用倾向匹配控制年龄、性别和Charlson共病指数(CCI)值。统计学和合并症、90天内科并发症和6个月外科并发症的比较采用卡方检验(α = 0.05)。结果:与对照组相比,大麻使用者术后90天内急性肾损伤、心脏骤停、深静脉血栓形成、低血糖、心肌梗死、肺炎、败血症、脑卒中、尿路感染的发生率均高于对照组(p < 0.01)。将大麻组与对照组比较,大麻组神经损伤发生率(p < 0.01)、骨折不愈合发生率(p = 0.04)、骨折不愈合发生率(p = 0.002)较高。与烟草使用者相比,大麻使用者在90天内肺炎(p = 0.002)、尿路感染(p < 0.01)和低血糖(p = 0.03)的发病率较低。结论:与没有药物使用史的患者相比,大麻使用者的几种内科和外科并发症发生率更高。与烟草使用者相比,大麻使用者的某些医疗并发症发生率较低。这些差异强调了为大麻使用者量身定制围手术期护理策略的必要性。证据等级:III级(治疗性)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
0.90
自引率
0.00%
发文量
304
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