Exploring the Impact of Prior Cannabis Use on 90-Day Complications Following Foot and Ankle Procedures: A Comprehensive Analysis and Clinical Implications

Category: Ankle; Midfoot/Forefoot Introduction/Purpose: With the rising prevalence of cannabis consumption among individuals undergoing foot and ankle procedures, there is a critical need for a comprehensive investigation into the impact of cannabis use on post-operative outcomes. The shifting socie...

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Main Authors: Arman Kishan MBBS, Sanjay Kubsad BS, Victoria E. Bergstein BA, Stanley E. Zhu BS, James R. Ficke MD, Amiethab A. Aiyer MD
Format: Article
Language:English
Published: SAGE Publishing 2024-12-01
Series:Foot & Ankle Orthopaedics
Online Access:https://doi.org/10.1177/2473011424S00284
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author Arman Kishan MBBS
Sanjay Kubsad BS
Victoria E. Bergstein BA
Stanley E. Zhu BS
James R. Ficke MD
Amiethab A. Aiyer MD
author_facet Arman Kishan MBBS
Sanjay Kubsad BS
Victoria E. Bergstein BA
Stanley E. Zhu BS
James R. Ficke MD
Amiethab A. Aiyer MD
author_sort Arman Kishan MBBS
collection DOAJ
description Category: Ankle; Midfoot/Forefoot Introduction/Purpose: With the rising prevalence of cannabis consumption among individuals undergoing foot and ankle procedures, there is a critical need for a comprehensive investigation into the impact of cannabis use on post-operative outcomes. The shifting societal attitudes towards cannabis, coupled with legislative changes promoting increased accessibility, underscore the urgency of understanding the implications for both patients and surgeons. This study aims to address this gap in knowledge and provide insights that can guide pre-operative evaluations and post-operative care planning. Methods: Utilizing data from PearlDiver, patients who underwent interphalangeal fusion, arthrodesis, arthroscopy, total ankle arthroplasty, ankle fracture repair, lateral ankle ligament reconstruction, calcaneal tendon repair, bunionectomy and calcaneal osteotomy were identified. These patients with prior history of cannabis use were propensity-matched with a cohort without prior history of cannabis use based on age, sex and Charlson Comorbidity Index in a 1:4 ratio. Both cohorts were evaluated for 90-day occurrence of medical complications using univariate analysis. Results: In this study, we matched 59,797 patients with a history of cannabis use undergoing foot or ankle procedures with 239,086 without such history. Those with prior cannabis use showed significantly elevated rates of medical conditions compared to controls: pneumonia (6.1% vs. 2.2%, p < .001), deep vein thrombosis (1.5% vs. 0.8%, p < .001), pulmonary embolism (0.4% vs. 0.2%, p < .001), myocardial infarction (1.6% vs. 0.5%, p < .001), stroke (1.8% vs. 0.8%, p < .001), surgical site infections (4.0% vs. 2.2%, p < .001), acute kidney injury (6.8% vs. 3.0%, p < .001), urinary tract infections (9.0% vs. 3.5%, p < .001), sepsis (4.6% vs. 2.0%, p < .001), and hypoglycemia (1.2% vs. 0.5%, p < .001). Conclusion: This study highlights a compelling correlation between prior cannabis use and heightened risks of medical complications post foot and ankle surgeries. The findings emphasize the imperative for healthcare professionals to include cannabis use history in pre-operative assessments and post-operative care planning. Acknowledging the evolving landscape of cannabis use among surgical patients, further research is essential to refine clinical approaches and enhance patient outcomes in this context.
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spelling doaj-art-cf170715b6e44de684dc060b03e6e8d52025-08-20T02:32:30ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142024-12-01910.1177/2473011424S00284Exploring the Impact of Prior Cannabis Use on 90-Day Complications Following Foot and Ankle Procedures: A Comprehensive Analysis and Clinical ImplicationsArman Kishan MBBSSanjay Kubsad BSVictoria E. Bergstein BAStanley E. Zhu BSJames R. Ficke MDAmiethab A. Aiyer MDCategory: Ankle; Midfoot/Forefoot Introduction/Purpose: With the rising prevalence of cannabis consumption among individuals undergoing foot and ankle procedures, there is a critical need for a comprehensive investigation into the impact of cannabis use on post-operative outcomes. The shifting societal attitudes towards cannabis, coupled with legislative changes promoting increased accessibility, underscore the urgency of understanding the implications for both patients and surgeons. This study aims to address this gap in knowledge and provide insights that can guide pre-operative evaluations and post-operative care planning. Methods: Utilizing data from PearlDiver, patients who underwent interphalangeal fusion, arthrodesis, arthroscopy, total ankle arthroplasty, ankle fracture repair, lateral ankle ligament reconstruction, calcaneal tendon repair, bunionectomy and calcaneal osteotomy were identified. These patients with prior history of cannabis use were propensity-matched with a cohort without prior history of cannabis use based on age, sex and Charlson Comorbidity Index in a 1:4 ratio. Both cohorts were evaluated for 90-day occurrence of medical complications using univariate analysis. Results: In this study, we matched 59,797 patients with a history of cannabis use undergoing foot or ankle procedures with 239,086 without such history. Those with prior cannabis use showed significantly elevated rates of medical conditions compared to controls: pneumonia (6.1% vs. 2.2%, p < .001), deep vein thrombosis (1.5% vs. 0.8%, p < .001), pulmonary embolism (0.4% vs. 0.2%, p < .001), myocardial infarction (1.6% vs. 0.5%, p < .001), stroke (1.8% vs. 0.8%, p < .001), surgical site infections (4.0% vs. 2.2%, p < .001), acute kidney injury (6.8% vs. 3.0%, p < .001), urinary tract infections (9.0% vs. 3.5%, p < .001), sepsis (4.6% vs. 2.0%, p < .001), and hypoglycemia (1.2% vs. 0.5%, p < .001). Conclusion: This study highlights a compelling correlation between prior cannabis use and heightened risks of medical complications post foot and ankle surgeries. The findings emphasize the imperative for healthcare professionals to include cannabis use history in pre-operative assessments and post-operative care planning. Acknowledging the evolving landscape of cannabis use among surgical patients, further research is essential to refine clinical approaches and enhance patient outcomes in this context.https://doi.org/10.1177/2473011424S00284
spellingShingle Arman Kishan MBBS
Sanjay Kubsad BS
Victoria E. Bergstein BA
Stanley E. Zhu BS
James R. Ficke MD
Amiethab A. Aiyer MD
Exploring the Impact of Prior Cannabis Use on 90-Day Complications Following Foot and Ankle Procedures: A Comprehensive Analysis and Clinical Implications
Foot & Ankle Orthopaedics
title Exploring the Impact of Prior Cannabis Use on 90-Day Complications Following Foot and Ankle Procedures: A Comprehensive Analysis and Clinical Implications
title_full Exploring the Impact of Prior Cannabis Use on 90-Day Complications Following Foot and Ankle Procedures: A Comprehensive Analysis and Clinical Implications
title_fullStr Exploring the Impact of Prior Cannabis Use on 90-Day Complications Following Foot and Ankle Procedures: A Comprehensive Analysis and Clinical Implications
title_full_unstemmed Exploring the Impact of Prior Cannabis Use on 90-Day Complications Following Foot and Ankle Procedures: A Comprehensive Analysis and Clinical Implications
title_short Exploring the Impact of Prior Cannabis Use on 90-Day Complications Following Foot and Ankle Procedures: A Comprehensive Analysis and Clinical Implications
title_sort exploring the impact of prior cannabis use on 90 day complications following foot and ankle procedures a comprehensive analysis and clinical implications
url https://doi.org/10.1177/2473011424S00284
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