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Marijuana use and perioperative outcomes in patients undergoing coronary artery bypass graft surgery: insight from the National Inpatient Sample (2008-2018)
Krishna Bellam1, Nishanth Chalasani2, Noah Feldman1, Sharif Sabe1, Timothy Sears3, Frank Sellke1, Afshin Ehsan1.
1Warren Alpert Medical School of Brown University, Providence, RI, USA, 2USF Morsani School of Medicine, Tampa, FL, USA, 3UC San Diego PHD in Bioinformatics, San Diego, CA, USA.

OBJECTIVE: While several studies have demonstrated an increase in admission for heart failure among patients who abuse marijuana, no study has yet explored the association between marijuana abuse and outcomes following CABG. We analyzed the relationship between marijuana abuse, postoperative morbidity, and resource utilization in patients who underwent CABG.
METHODS: Using Nationwide Inpatient Sample (NIS) data from 2008-2018 for patients ≥ 18 years old, we examined the association between marijuana use and both outcomes and resource utilization following CABG procedures. Patients were divided into two groups based on cannabis use status (abuse/dependence vs. non-use). Primary outcomes include in-hospital mortality, favorable discharge, and LOS. Patient characteristics including age, sex, race, and comorbidities were included. Multivariable models were used for the various outcomes and each model adjusted for confounding variables.RESULTS: When compared to non-cannabis use, cannabis abuse and dependence were associated with significantly increased odds of discharge not to home (OR = 1.50, p<.001), acute kidney injury (OR = 1.40, p=.005), acute myocardial infarction (OR = 1.56, p<.001), TIA stroke (OR = 1.64, p=.001), and a greater length of stay (mean 10.4 days vs 9.8 days; OR = 1.14, p<.001) Interestingly, cannabis abuse and dependence were associated with significantly decreased odds of hemodialysis (OR= 0.48, p=.001).
CONCLUSIONS: In our cohort, cannabis use and dependence were associated with an increased risk for AKI, AMI, TIA stroke, and longer length of stay, and a decreased risk for hemodialysis. Further studies are needed to elucidate the causal relationship between marijuana use and unfavorable CABG outcomes.


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