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大麻使用障碍与初次1至2级腰椎融合术后更长的住院时间、更高的医疗并发症发生率及护理费用相关。

Cannabis Use Disorder Is Associated With Longer In-Hospital Lengths of Stay, Higher Rates of Medical Complications, and Costs of Care Following Primary 1- to 2-Level Lumbar Fusion.

作者信息

Jain Shreya, Cloud Geoffrey W, Gordon Adam M, Lam Aaron W, Vakharia Rushabh M, Saleh Ahmed, Razi Afshin E

机构信息

Department of Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, NY, USA.

College of Medicine, State University of New York Downstate, Brooklyn, NY, USA.

出版信息

Global Spine J. 2024 Jan;14(1):67-73. doi: 10.1177/21925682221093965. Epub 2022 Apr 8.

Abstract

STUDY DESIGN

Retrospective case-control study.

OBJECTIVES

The purpose of this study is to assess whether cannabis use disorder (CUD) patients undergoing primary 1- to 2-level lumbar fusion (1-2LF) for the treatment of degenerative lumbar spine disorders have higher rates of: (1) in-hospital lengths of stay (LOS), (2) medical complications, and (3) healthcare expenditures.

MATERIALS AND METHODS

A retrospective case-control study of the MSpine dataset of the PearlDiver claims from January 2007 to March 2018 was performed. Patients with CUD undergoing 1-2LF were queried and matched to a comparison group in a 1:5 ratio by age, sex, and various medical comorbidities yielding 22, 815 patients within the study (CUD = 3805; control = 19 010). Outcomes analyzed included LOS, 90-day medical complications, and costs. A value less than .004 was considered significant.

RESULTS

This study found CUD patients undergoing primary 1-2LF experience longer in-hospital LOS (4- vs. 3-days, .0001). Additionally, CUD patients were found to have significantly higher frequency and odds-ratios (OR) (31.88 vs. 18.01% OR: 1.41, .0001) of adverse events within ninety days following their procedure. CUD patients also had significantly higher day of surgery ($18,946.79 vs. $15,691.02, < .0001) and 90 days healthcare expenditures ($21,469.01 vs. $19,556.71, < .0001).

CONCLUSION

Patients with CUD can prepare for increased LOS, complications, and costs following primary 1-2LF. The study can be used to educate these patients of the potential outcomes following their procedure.

摘要

研究设计

回顾性病例对照研究。

目的

本研究的目的是评估因退行性腰椎疾病接受初次1至2节段腰椎融合术(1-2LF)的大麻使用障碍(CUD)患者是否在以下方面有更高的发生率:(1)住院时间(LOS),(2)医疗并发症,以及(3)医疗保健支出。

材料与方法

对2007年1月至2018年3月PearlDiver索赔的MSpine数据集进行回顾性病例对照研究。查询接受1-2LF的CUD患者,并按年龄、性别和各种合并症以1:5的比例与对照组匹配,研究中共纳入22815例患者(CUD = 3805;对照组 = 19010)。分析的结果包括住院时间、90天医疗并发症和费用。小于0.004的值被认为具有统计学意义。

结果

本研究发现接受初次1-2LF的CUD患者住院时间更长(4天对3天,P < 0.0001)。此外,发现CUD患者在手术后90天内不良事件的发生率和优势比(OR)显著更高(31.88%对18.01%,OR:1.41,P < 0.0001)。CUD患者的手术日费用(18946.79美元对15691.02美元,P < 0.0001)和90天医疗保健支出(21469.01美元对19556.71美元,P < 0.0001)也显著更高。

结论

CUD患者可以为初次1-2LF术后住院时间延长、并发症增加和费用增加做好准备。该研究可用于告知这些患者手术的潜在结果。

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