Teens With Cannabis Use Disorder Face Higher Rates of Complications After Surgery
Among over 558,000 adolescents who underwent surgery, those with cannabis use disorder had significantly higher odds of respiratory complications, ICU admission, mechanical ventilation, and extended hospital stays.
Quick Facts
What This Study Found
CUD prevalence in adolescent surgical patients increased from 0.4% in 2009 to 0.6% in 2022. Adolescents with CUD had significantly higher adjusted odds of respiratory complications (OR 1.52), ICU admission (OR 1.78), mechanical ventilation (OR 2.41), and extended hospital stays (OR 1.96). Mortality and stroke risks were not significantly increased after Bonferroni correction.
Key Numbers
558,721 adolescents. 2,604 (0.5%) with CUD. CUD prevalence increased from 0.4% (2009) to 0.6% (2022), p < .001. Adjusted ORs: respiratory complications 1.52 (1.16-2.00), ICU admission 1.78 (1.61-1.98), mechanical ventilation 2.41 (2.10-2.77), extended hospital stay 1.96 (1.74-2.20). All p < .001 except respiratory (p = .002).
How They Did This
Retrospective 1:1 propensity-matched cohort study of 558,721 adolescents (ages 10-17) undergoing inpatient surgery at US hospitals in the Pediatric Health Information System from 2009-2022. 2,604 had CUD diagnoses; 2,483 were propensity matched. Bonferroni-corrected significance threshold: p < .008.
Why This Research Matters
This is the largest study to date examining how cannabis use disorder affects surgical outcomes in teens. The 2.4-fold increase in mechanical ventilation risk is particularly concerning and suggests CUD should be part of preoperative assessment and counseling for adolescents.
The Bigger Picture
As cannabis use disorder becomes more common among adolescents, perioperative teams need to account for its effects on recovery. The respiratory and ICU findings suggest cannabis-related airway and pulmonary effects may be clinically significant even in young patients.
What This Study Doesn't Tell Us
CUD was identified by diagnostic codes, which likely undercount actual cannabis use. The study cannot distinguish between active use and historical CUD diagnosis. Propensity matching cannot account for unmeasured confounders like the severity of the underlying surgical condition.
Questions This Raises
- ?Would preoperative cannabis cessation reduce complication rates?
- ?What is the mechanism behind the increased mechanical ventilation risk -- is it primarily respiratory or related to altered anesthetic metabolism?
Trust & Context
- Key Stat:
- 2.41x higher odds of mechanical ventilation in adolescent surgical patients with CUD
- Evidence Grade:
- Strong: very large multicenter database with propensity matching, Bonferroni correction, and consistent findings across multiple outcomes.
- Study Age:
- 2024 study using 2009-2022 data.
- Original Title:
- Trends in Adolescent Comorbid Cannabis Use Disorder and Postoperative Complications.
- Published In:
- Pediatrics, 153(6) (2024)
- Authors:
- Willer, Brittany L, Mpody, Christian, Nafiu, Olubukola O
- Database ID:
- RTHC-05818
Evidence Hierarchy
Looks back at existing records to find patterns.
What do these levels mean? →Frequently Asked Questions
Why does cannabis use disorder increase surgical risks?
The mechanisms are not fully established, but cannabis smoking can impair airway function and lung health. THC also interacts with anesthetic agents and may alter pain perception and analgesic requirements, all of which could contribute to respiratory complications and longer recoveries.
Is the risk increasing over time?
CUD prevalence among adolescent surgical patients increased 50% from 2009 to 2022 (0.4% to 0.6%), and this likely underestimates actual use. As rates continue to rise, the absolute number of teens experiencing these complications will grow.
Read More on RethinkTHC
Cite This Study
https://rethinkthc.com/research/RTHC-05818APA
Willer, Brittany L; Mpody, Christian; Nafiu, Olubukola O. (2024). Trends in Adolescent Comorbid Cannabis Use Disorder and Postoperative Complications.. Pediatrics, 153(6). https://doi.org/10.1542/peds.2024-065757
MLA
Willer, Brittany L, et al. "Trends in Adolescent Comorbid Cannabis Use Disorder and Postoperative Complications.." Pediatrics, 2024. https://doi.org/10.1542/peds.2024-065757
RethinkTHC
RethinkTHC Research Database. "Trends in Adolescent Comorbid Cannabis Use Disorder and Post..." RTHC-05818. Retrieved from https://rethinkthc.com/research/willer-2024-trends-in-adolescent-comorbid
Access the Original Study
Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.
This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.