Adverse Events After Ankle Fracture Open Reduction Internal Fixation Among Patients With and Without Documented Cannabis and Tobacco Use.

IF 2.4 2区医学 Q2 ORTHOPEDICS Foot & Ankle International Pub Date : 2023-10-01 Epub Date: 2023-09-12 DOI:10.1177/10711007231189698

Meera M Dhodapkar, Oghenewoma P Oghenesume, Scott J Halperin, Maxwell Modrak, Brad J Yoo, Jonathan N Grauer

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Abstract

Background: Ankle fractures are common orthopaedic injuries that may be indicated for open reduction internal fixation (ORIF). Although the negative impact of tobacco use on perioperative outcomes of ankle fracture ORIF has been described, the potential impact of cannabis use on related outcomes is not as well established.

Methods: Retrospective database study of adult patients undergoing ankle ORIF for closed, isolated, ankle fractures from the 2010-2021 Q1 PearlDiver M151 data set. Subcohorts without and with cannabis and/or tobacco use were identified based on coding and matched based on patient age, sex, and Elixhauser Comorbidity Index (ECI) scores to yield groups of nonusers, tobacco users, tobacco and cannabis users, and cannabis users. Ninety-day adverse events were assessed between matched subcohorts with multivariable logistic regression controlling for age, sex, and ECI.

Results: A total of 149 289 patients met study inclusion criteria for whom tobacco only use was documented for 14 989 (10.0%), tobacco and cannabis use for 2726 (1.8%), and cannabis only use for 867 (0.6%). Matching yielded 823 for each group. On multivariable analyses, isolated tobacco users were at higher odds of 90-day urinary tract infections (UTIs) (odds ratio [OR] 2.64), minor adverse events (OR 2.33), all-cause adverse events (OR 2.17), readmissions (OR 1.85), and severe adverse events (OR 1.84). Tobacco and cannabis comorbid users were at a marginally higher odds of 90-day UTI (OR 2.82), minor adverse events (OR 2.51), readmissions (OR 2.39), and any adverse events (OR 2.22). Cannabis only users were not at greater odds of 90-day adverse events relative to nonusers.

Conclusion: Patients with tobacco use (alone or with cannabis) were at greater odds of 90-day adverse events following ankle fracture ORIF, but cannabis only users were not.

Level of evidence: Level III, Retrospective database study.

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有和无大麻和烟草使用记录的患者踝关节骨折切开复位内固定术后的不良事件。

背景：踝关节骨折是常见的骨科损伤，可用于开放复位内固定（ORIF）。尽管已经描述了吸烟对踝关节骨折ORIF围手术期结果的负面影响，但大麻使用对相关结果的潜在影响尚不明确。方法：根据2010-2021年Q1 PearlDiver M151数据集，对接受踝关节ORIF治疗闭合性、孤立性踝关节骨折的成年患者进行回顾性数据库研究。根据编码确定未使用和有使用大麻和/或烟草的亚群体，并根据患者年龄、性别和Elixhauser共病指数（ECI）得分进行匹配，以产生非使用者、烟草使用者、烟草和大麻使用者以及大麻使用者组。采用控制年龄、性别和ECI的多变量逻辑回归法，在匹配的亚组之间评估90天的不良事件。结果：共149例 289名患者符合研究纳入标准，其中14名患者仅使用烟草 989人（10.0%），2726人（1.8%）使用烟草和大麻，867人（0.6%）仅使用大麻。每组匹配产生823人。在多变量分析中，隔离烟草使用者发生90天尿路感染（UTI）（比值比[OR]2.64）、轻微不良事件（OR 2.33）、全因不良事件（OR2.17）、再次入院（OR 1.85）和严重不良事件（Or1.84）的几率更高，再次入院（OR 2.39）和任何不良事件（OR 2.22）。与非使用者相比，仅使用大麻的使用者发生90天不良事件的几率并不高。结论：使用烟草（单独或与大麻一起）的患者在踝关节骨折ORIF后90天发生不良事件的几率更大，但仅使用大麻的患者则不然。证据级别：三级，回顾性数据库研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Foot & Ankle International 医学-整形外科

CiteScore

5.60

自引率

22.20%

发文量

144

审稿时长

2 months

期刊介绍： Foot & Ankle International (FAI), in publication since 1980, is the official journal of the American Orthopaedic Foot & Ankle Society (AOFAS). This monthly medical journal emphasizes surgical and medical management as it relates to the foot and ankle with a specific focus on reconstructive, trauma, and sports-related conditions utilizing the latest technological advances. FAI offers original, clinically oriented, peer-reviewed research articles presenting new approaches to foot and ankle pathology and treatment, current case reviews, and technique tips addressing the management of complex problems. This journal is an ideal resource for highly-trained orthopaedic foot and ankle specialists and allied health care providers. The journal’s Founding Editor, Melvin H. Jahss, MD (deceased), served from 1980-1988. He was followed by Kenneth A. Johnson, MD (deceased) from 1988-1993; Lowell D. Lutter, MD (deceased) from 1993-2004; and E. Greer Richardson, MD from 2005-2007. David B. Thordarson, MD, assumed the role of Editor-in-Chief in 2008. The journal focuses on the following areas of interest: • Surgery • Wound care • Bone healing • Pain management • In-office orthotic systems • Diabetes • Sports medicine

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