大麻和烟草使用与踝关节和后足关节融合术后并发症的关联。
The Association of Cannabis and Tobacco Use With Postoperative Complications after Ankle and Hindfoot Arthrodesis.
作者信息
Holle Alejandro M, Beckett Nathan C, Iturregui Jose M, Haglin Jack M, Kile Todd A
机构信息
Mayo Clinic Alix School of Medicine, Phoenix AZ, USA.
Department of Orthopaedic Surgery, Mayo Clinic, Phoenix, AZ, USA.
出版信息
Foot Ankle Orthop. 2025 Apr 11;10(2):24730114251328669. doi: 10.1177/24730114251328669. eCollection 2025 Apr.
BACKGROUND
The purpose of this study was to investigate the association between cannabis use and postoperative complications following ankle and hindfoot arthrodesis.
METHODS
A retrospective cohort study using a large national insurance database from 2010 to 2022 was conducted. All patients who underwent ankle or hindfoot arthrodesis with at least 2 years' follow-up were included. Patients were divided into 4 groups: cannabis-only users, tobacco-only users, cannabis and tobacco users, and nonuser controls. Groups were matched 1:4 with nonuser controls based on demographic variables and comorbidities. Also, both cannabis and tobacco users were matched 1:4 with tobacco-only users based on demographics and comorbidities. Medical complications within 90 days of surgery and surgery-specific complications within 2 years were compared between groups with multivariable logistic regressions.
RESULTS
Compared with nonuser controls, cannabis users only were not at increased risk of 90-day medical complications or 2-year surgical complications. Tobacco use alone was associated with increased risk of postoperative admission (OR 1.32, 95% CI 1.21-1.43) and emergency department (ED) utilization (OR 1.57, 95% CI 1.48-1.66) within 90 days as well as infection (OR 1.24, 95% CI 1.18-1.30), hardware removal (OR 1.12, 95% CI 1.07-1.18), nonunion (OR 1.33, 95% CI 1.27-1.40), and wound dehiscence (OR 1.38, 95% CI 1.27-1.49) within 2 years of surgery compared with nonuser controls. Compared with tobacco-only use, combined cannabis and tobacco use was associated with increased risk of ED visits within 90 days (OR 1.45, 95% CI 1.30-1.62) and nonunion within 2 years of surgery (OR 1.19, 95% CI 1.05-1.35).
CONCLUSION
These findings suggest that although cannabis use alone was not associated with a higher risk of postoperative complications, its concurrent use with tobacco was linked to greater rates of adverse outcomes.
LEVEL OF EVIDENCE
Level III, retrospective case control study.
背景
本研究旨在调查大麻使用与踝关节和后足关节融合术后并发症之间的关联。
方法
利用2010年至2022年的大型国家保险数据库进行了一项回顾性队列研究。纳入所有接受踝关节或后足关节融合术且至少随访2年的患者。患者分为4组：仅使用大麻者、仅使用烟草者、同时使用大麻和烟草者以及非使用者对照组。根据人口统计学变量和合并症，将各组与非使用者对照组按1:4进行匹配。此外，同时使用大麻和烟草者与仅使用烟草者也根据人口统计学和合并症按1:4进行匹配。通过多变量逻辑回归比较各组在术后90天内的医疗并发症和2年内的手术特定并发症。
结果
与非使用者对照组相比，仅使用大麻者在90天医疗并发症或2年手术并发症方面风险未增加。单独使用烟草与术后90天内入院风险增加（比值比1.32，95%置信区间1.21 - 1.43）、急诊科就诊风险增加（比值比1.57，95%置信区间1.48 - 1.66）以及与非使用者对照组相比，术后2年内感染风险增加（比值比1.24，95%置信区间1.18 - 1.30）、取出内固定物风险增加（比值比1.12，95%置信区间1.07 - 1.18）、骨不连风险增加（比值比1.33，95%置信区间1.27 - 1.40）和伤口裂开风险增加（比值比1.38，95%置信区间1.27 - 1.49）相关。与仅使用烟草相比，同时使用大麻和烟草与术后90天内急诊科就诊风险增加（比值比1.45，95%置信区间1.30 - 1.62）以及术后2年内骨不连风险增加（比值比1.19，95%置信区间1.05 - 1.35）相关。
结论
这些发现表明，尽管单独使用大麻与术后并发症风险较高无关，但其与烟草同时使用则与更高的不良结局发生率相关。
证据级别
三级，回顾性病例对照研究。
Zotero 插件