Northwestern University Feinberg School of Medicine, Chicago, IL, 60611, USA.
University of Miami Miller School of Medicine, Miami, FL, 33136, USA.
Obes Surg. 2023 May;33(5):1333-1337. doi: 10.1007/s11695-023-06552-z. Epub 2023 Mar 16.
In the United States, recreational and medicinal cannabis use has continually increased in recent years, including in patients undergoing bariatric surgery. However, the effects of cannabis use on morbidity and mortality after bariatric surgery are uncertain, and the literature is limited by a paucity of studies. This study intends to evaluate the effects of cannabis use disorder on outcomes in patients undergoing bariatric surgery.
The National Inpatient Sample 2016-2019 was queried for patients ≥ 18 years who underwent roux-en-y gastric bypass (RYGB), vertical sleeve gastrectomy (VSG), or adjustable gastric band (AGB) surgery. Cannabis use disorder was identified using ICD-10 coding. Three outcomes were evaluated: medical complications, in-hospital mortality, and length of stay. Logistic regression was used to evaluate effects of cannabis use disorder on medical complications and in-hospital mortality, and linear regression for length of stay. All models controlled for race, age, sex, income, procedure type, and various medical comorbidities.
A total of 713,290 patients were included in this study, with 1,870 (0.26%) having cannabis use disorder. Cannabis use disorder was associated with medical complications (OR: 2.24; 95% CI: 1.31-3.82; P = 0.003) and longer lengths of stay (β: 1.3; SE: 0.297; P < 0.001), but not in-hospital mortality (OR: 3.29; CI: 0.94-11.5); P = 0.062).
Severe cannabis use was associated with higher risk for complications and extended length of stay. Future investigations are needed to better elucidate the relationship between cannabis use and bariatric surgery, including effects of dosage, chronicity, and method of ingestion.
近年来,美国娱乐性和药用大麻的使用不断增加,包括在接受减重手术的患者中。然而,大麻使用对减重手术后发病率和死亡率的影响尚不确定,并且由于研究较少,文献也有限。本研究旨在评估大麻使用障碍对接受减重手术患者结局的影响。
2016 年至 2019 年,通过国际疾病分类第 10 次修订版(ICD-10)编码,在全国住院患者样本中查询了年龄≥18 岁、接受 Roux-en-Y 胃旁路术(RYGB)、垂直袖状胃切除术(VSG)或可调胃束带术(AGB)的患者。大麻使用障碍的诊断采用 ICD-10 编码。评估了 3 种结局:医疗并发症、院内死亡率和住院时间。采用 logistic 回归评估大麻使用障碍对医疗并发症和院内死亡率的影响,采用线性回归评估住院时间。所有模型均控制了种族、年龄、性别、收入、手术类型和各种合并症。
本研究共纳入 713290 例患者,其中 1870 例(0.26%)患有大麻使用障碍。大麻使用障碍与医疗并发症(OR:2.24;95%CI:1.31-3.82;P=0.003)和住院时间延长(β:1.3;SE:0.297;P<0.001)相关,但与院内死亡率(OR:3.29;CI:0.94-11.5;P=0.062)无关。
严重的大麻使用与并发症风险增加和住院时间延长有关。需要进一步研究以更好地阐明大麻使用与减重手术之间的关系,包括剂量、持续性和摄入方式的影响。