Wakefield Connor J, Seder Christopher W, Arndt Andrew T, Geissen Nicole, Liptay Michael J, Karush Justin M
Department of Cardiovascular and Thoracic Surgery, Rush University Medical Center, Chicago, IL, United States.
Front Surg. 2021 May 25;8:668588. doi: 10.3389/fsurg.2021.668588. eCollection 2021.
Primary spontaneous pneumothorax (PSP) is a frequently encountered entity that carries a high rate of recurrence. The current study aims to investigate if cannabis use at time of initial PSP is associated with disease recurrence. Patients presenting with PSP between 2010 and 2018 at a single institution were identified. Exclusion criteria included secondary pneumothorax, severe chronic lung disease, lung cancer, and lost to follow-up. Patients were compared relative to their cannabis usage with Fisher's exact test, Wilcoxon rank-sum test, and logistic regression. Overall, 67 patients (53 male) met inclusion criteria with a median body mass index (BMI) of 21.5 kg/m (IQR 19.1-25.2) and age of 34 years (IQR 22-53). Initial treatment consisted of chest tube in 42 patients (63%), video-assisted thoracoscopic surgery wedge resection in 19 patients (28%), and observation in 6 patients (9%). Cannabis users ( = 28; 42%) had a higher rate of tobacco use (79 vs. 38%; = 0.005), lower BMI [21.0 kg/m (IQR 18.3-23.1) vs. 22.2 kg/m (IQR 19.9-28.6), = 0.037], and were more likely to require intervention at first presentation compared with non-marijuana users. Cannabis use was associated with PSP recurrence when adjusting for tobacco use, BMI, and height (OR 1.85, 95% CI 1.38-18.3, = 0.014). There is a high rate of cannabis usage in patients presenting with PSP. Cannabis usage is associated with PSP recurrence and eventual need for operative intervention.
原发性自发性气胸（PSP）是一种常见疾病，复发率很高。本研究旨在调查初次发生PSP时使用大麻是否与疾病复发有关。确定了2010年至2018年在单一机构就诊的PSP患者。排除标准包括继发性气胸、严重慢性肺病、肺癌和失访。采用Fisher精确检验、Wilcoxon秩和检验和逻辑回归对患者的大麻使用情况进行比较。总体而言，67例患者（53例男性）符合纳入标准，中位体重指数（BMI）为21.5kg/m²（四分位间距19.1-25.2），年龄为34岁（四分位间距22-53）。42例患者（63%）的初始治疗为胸腔闭式引流，19例患者（28%）为电视辅助胸腔镜手术楔形切除术，6例患者（9%）为观察等待。大麻使用者（n = 28；42%）吸烟率较高（79%对38%；P = 0.005），BMI较低[21.0kg/m²（四分位间距18.3-23.1）对22.2kg/m²（四分位间距19.9-28.6），P = 0.037]，与非大麻使用者相比，初次就诊时更有可能需要干预。在调整吸烟、BMI和身高后，使用大麻与PSP复发相关（比值比1.85，95%置信区间1.38-18.3，P = 0.014）。PSP患者中大麻使用率很高。使用大麻与PSP复发以及最终需要手术干预有关。
