SEVERE CANNABIS USE PREDISPOSES ADVERSE OUTCOMES AFTER BARIATRIC SURGERY
Rohan M. Shah*1, Shiv Patel1, Lakhvir Sandhu2, Shrey Patel3, Bipan Chand2
1Northwestern University Feinberg School of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, US, academic/medsch, Chicago, IL; 2Loyola University Chicago Stritch School of Medicine, Maywood, IL; 3University of Miami School of Medicine, Miami, FL
Introduction:
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 current literature is limited by a paucity of studies. The purpose of this study is to evaluate the effects of cannabis use disorder on medical complications, in-hospital mortality, and length of stay (LOS) in a nationally representative cohort of patients undergoing bariatric surgery.
Methods:
The Nationwide Inpatient Sample 2016 - 2019 was queried for all patients ≥18 years who underwent roux-en-y gastric bypass (RYGB), vertical sleeve gastrectomy (VSG), or adjustable gastric band (AGB) surgery. Severe cannabis use was defined using ICD-10 coding for cannabis use disorder. Three outcomes were evaluated: medical complications, in-hospital mortality, and length of stay. Complications were defined as experiencing ≥1 myocardial infarction, cardiac arrest, venous thromboembolism (VTE), pulmonary embolism (PE), respiratory arrest, pneumonia, sepsis, stroke, and/or urinary/renal complication. Logistic regressions were used to evaluate effects of cannabis use disorder on medical complications and in-hospital mortality. Linear regression was used to determine an association with length of stay. All models controlled for race, age, sex, income, procedure type, and various medical comorbidities (hypertension, history of cancer, diabetes, and respiratory conditions).
Results:
A total of 713,290 patients were included in this study, with 1,870 (0.26%) having documented cannabis use disorder. Cannabis use disorder was significantly associated with the likelihood of experiencing a medical complication (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).
Conclusions:
Severe cannabis use was associated with a 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.
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