Among 713,290 bariatric surgery patients in a nationwide database, those with cannabis use disorder had 2.24 times higher odds of medical complications and significantly longer hospital stays, though no significant difference in mortality was found.
Bariatric surgeons, anesthesiologists, perioperative medicine specialists.
Cannabis use disorder doubled complication risk after bariatric surgery
What the researchers found
Cannabis use disorder (0.26% of patients) was associated with medical complications (OR: 2.24; 95% CI: 1.31-3.82; P=0.003) and longer hospital stays (beta: 1.3 days; P<0.001). In-hospital mortality trended higher but did not reach significance (OR: 3.29; P=0.062). Analyses controlled for race, age, sex, income, procedure type, and comorbidities.
Why it matters
Bariatric surgery is increasingly common, and surgeons need to know if cannabis use affects outcomes. The doubled complication rate suggests cannabis use disorder should be part of preoperative risk assessment.
The numbers in context
N=713,290 bariatric patients. CUD prevalence: 0.26% (1,870 patients). Complications OR=2.24 (P=0.003). Length of stay: +1.3 days (P<0.001). Mortality OR=3.29 (P=0.062, not significant).
How the study worked
Retrospective nationwide study using the National Inpatient Sample 2016-2019. Queried patients 18+ undergoing RYGB, VSG, or AGB surgery. Cannabis use disorder identified by ICD-10 coding. Logistic and linear regression models.
What this study cannot tell us
Administrative database with ICD-10 coding may underestimate cannabis use (0.26% is far below population prevalence). Cannot distinguish active use from historical CUD diagnosis. Cannot determine dose, frequency, or route of cannabis use. Cannot establish causation.
How to read the evidence
Large nationwide database study with multivariable adjustment, but limited by ICD-10 coding and inability to assess actual cannabis use patterns.
When this study was published
Published in 2023 using NIS data from 2016-2019.
The bigger picture
As both bariatric surgery and cannabis use increase, their intersection becomes more common. Whether the increased complications are from cannabis itself (e.g., effects on anesthesia, wound healing, or pain management) or from associated lifestyle factors remains to be determined.
Questions still open
- Should bariatric surgery programs screen for cannabis use disorder as part of preoperative evaluation?
- Is the increased complication risk from cannabis effects on healing, anesthesia interaction, or confounding factors?
Common questions
Does cannabis use affect bariatric surgery outcomes?
Should cannabis users avoid bariatric surgery?
Read the original research
Severe Cannabis use is Associated with Complications and Prolonged Length of Stay in Bariatric Surgery.
Obesity surgery, 33(5), 1333-1337
Citation
Shah, Rohan M; Patel, Shrey; Patel, Shiv; Sandhu, Lakhvir Kaur; Chand, Bipan. (2023). Severe Cannabis use is Associated with Complications and Prolonged Length of Stay in Bariatric Surgery.. Obesity surgery, 33(5), 1333-1337. https://doi.org/10.1007/s11695-023-06552-z
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