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Self-Reported Cannabis Use Is Not Associated With Increased Opioid Use or Costs After Hip Arthroscopy
Jacob T Wood1, Senthil Sambandam2, Dane K Wukich3
1University of Texas Southwestern School of Medicine, Dallas, Texas, U.S.A.
Insights
Perioperative cannabis use does not significantly impact opioid consumption or healthcare costs after hip arthroscopy. This study found no major differences in outcomes for patients using cannabis versus those who did not.
Area of Science:
- Orthopedic Surgery
- Pharmacology
- Health Economics
Background:
- Hip arthroscopy is a common orthopedic procedure.
- The influence of perioperative cannabis use on surgical outcomes is an area of growing interest.
- Understanding the economic and clinical implications of cannabis use in surgical patients is crucial for evidence-based practice.
Purpose of the Study:
- To compare the cost, opioid utilization, and complication rates following hip arthroscopy in patients with and without perioperative cannabis use.
- To evaluate the association between cannabis use and postoperative outcomes in hip arthroscopy patients.
Main Methods:
- Retrospective cohort study using a large commercial insurance database (2010-2019).
- Patients undergoing hip arthroscopy were identified and matched based on demographics, comorbidities, and lifestyle factors.
- Opioid use (Morphine Milligram Equivalents) and 30-day episode of care costs were compared between cannabis users and non-users.
Main Results:
- No significant difference in prescription opioid use between patients with (1,840 ± 2,743 MME) and without (2,129 ± 3,383 MME) reported cannabis use.
- Episode of care costs were not significantly different between the groups ($2957 ± $4428 for cannabis users vs. $2,651 ± $3,762 for non-users).
- A small percentage (0.71%) of queried patients had preoperative cannabis use diagnoses.
Conclusions:
- Perioperative cannabis use in hip arthroscopy patients is not associated with significantly different postoperative opioid requirements.
- The cost of the episode of care following hip arthroscopy does not appear to be significantly affected by perioperative cannabis use.
- These findings suggest that cannabis use may not alter key economic and clinical outcomes in the context of hip arthroscopy.
Purpose:
Our purpose is to determine the difference in cost, opioid use, and complication rates following hip arthroscopy with or without perioperative cannabis use.
Methods:
Data were collected from a large commercial insurance database (PearlDiver) between the years 2010 and 2019. Patients who underwent hip arthroscopy with reported cannabis use were identified using Common Procedural Terminology codes and the appropriate International Classification of Diseases codes. This group was then matched by age, procedure, gender, Charleston Comorbidity Index, Elixhauser Comorbidity Index), obesity, tobacco use, diabetes to a group of similar patients without self-reported cannabis use. Opioid use over the episode of care, evaluated by morphine milligram equivalents (MME), and 30-day cost were compared between groups using unequal variance t-test.
Results:
Of queried patients, 360 (.71%) had a diagnosis of preoperative cannabis use, abuse, or dependence within 5 years prior to their hip arthroscopy. A total of 300 patients (172 female, 128 male) were matched into each hip arthroscopy group, with and without cannabis. Of those patients, 171 without cannabis use and 174 with cannabis use had full financial and opioid use data for analysis. Prescription opioid use was not significantly different over the episode of care in patients with reported cannabis use (1,840 ± 2,743 MME) than those without reported cannabis use (2,129 ± 3,383 MME) (P = .3848). Additionally, episode of care reimbursement cost following hip arthroscopy did not differ significantly between patients with cannabis use ($2957 ± $4428) and those without reported cannabis use ($2,651 ± $3,762) (P = .3620).
Conclusions:
Following hip arthroscopy, patients with reported cannabis use do not appear to have significantly different postoperative opioid use or cost of hip arthroscopy episode of care compared with patients without reported cannabis use.
Level Of Evidence:
III, cohort study.
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