{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T10:05:07Z","timestamp":1783764307474,"version":"3.55.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2019,7,1]],"date-time":"2019-07-01T00:00:00Z","timestamp":1561939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Substance Abuse"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The association between marijuana use and surgical procedures is a matter of increasing societal relevance that has not been well studied in the literature. The primary aim of this study is to evaluate the relationship between marijuana use and in-hospital mortality, as well as to assess associated comorbidities in patients undergoing commonly billed orthopedic surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The National Inpatient Sample (NIS) database from 2010 to 2014 was used to determine the odds ratios for the associations between marijuana use and in-hospital mortality, heart failure (HF), stroke, and cardiac disease (CD) in patients undergoing 5 common orthopedic procedures: total hip (THA), total knee (TKA), and total shoulder (TSA) arthroplasties, spinal fusion, and traumatic femur fracture fixation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 9,561,963 patients who underwent one of the 5 selected procedures in the 4-year period, 26,416 (0.28%) were identified with a diagnosis of marijuana use disorder. In hip and knee arthroplasty patients, marijuana use was associated with decreased odds of mortality compared with no marijuana use (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001) and increased odds of HF (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .018), stroke (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0068), and CD (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0123). Traumatic femur fixation patients had the highest prevalence of marijuana use (0.70%), which was associated with decreased odds of mortality (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0483), HF (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0076), and CD (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0003). For spinal fusions, marijuana use was associated with increased odds of stroke (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001) and CD (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .0001). Marijuana use in patients undergoing total shoulder arthroplasty was associated with decreased odds of mortality (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001) and stroke (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this study, marijuana use was associated with decreased mortality in patients undergoing THA, TKA, TSA, and traumatic femur fixation, although the significance of these findings remains unclear. More research is needed to provide insight into these associations in a growing surgical population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1080\/08897077.2018.1449054","type":"journal-article","created":{"date-parts":[[2018,3,20]],"date-time":"2018-03-20T15:23:05Z","timestamp":1521559385000},"page":"378-382","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":60,"title":["Marijuana Use and Mortality following Orthopedic Surgical Procedures"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7509-2080","authenticated-orcid":false,"given":"Andrew S.","family":"Moon","sequence":"first","affiliation":[{"name":"Tufts University School of Medicine, Boston, Massachusetts, USA"},{"name":"Department of Orthopaedics, University of Alabama at Birmingham, UAB Highlands, Birmingham, Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Alabama at Birmingham, UAB Highlands, Birmingham, Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sawyer","family":"Mullen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Alabama at Birmingham, UAB Highlands, Birmingham, Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent A.","family":"Ponce","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Alabama at Birmingham, UAB Highlands, Birmingham, Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald","family":"McGwin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Alabama at Birmingham, UAB Highlands, Birmingham, Alabama USA"},{"name":"Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Alabama at Birmingham, UAB Highlands, Birmingham, Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer M.","family":"Naranje","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Alabama at Birmingham, UAB Highlands, Birmingham, Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2019,7,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1500043"},{"key":"e_1_3_2_3_2","unstructured":"McCarthy J. One in Eight U.S. Adults Say They Smoke Marijuana. Gallup.com. http:\/\/www.gallup.com\/poll\/194195\/adults-say-smoke-marijuana.aspx. Published August 8 2016. Accessed August 28 2017."},{"key":"#cr-split#-e_1_3_2_4_2.1","unstructured":"National Conference of State Legislation. [updated 2017 August 30"},{"key":"#cr-split#-e_1_3_2_4_2.2","unstructured":"accessed 2017 July 12]. http:\/\/www.ncsl.org\/research\/health\/state-medical-marijuana-laws.aspx."},{"key":"e_1_3_2_5_2","unstructured":"Center for Behavioral Health Statistics and Quality. Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16\u20134984 NSDUH Series H-51). Retrieved from http:\/\/www.samhsa.gov\/data\/. 2016."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.6358"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1402309"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.113.000638"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.nrl.0000107493.19282.b0"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/cpt.721"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2015.01.052"},{"key":"e_1_3_2_12_2","unstructured":"Fingar KR Stocks C Weiss AJ Steiner CA. Most frequent operating room procedures performed in U.S. hospitals 2003\u20132012. HCUP Statistical Brief #186. Agency for Healthcare Research and Quality Rockville MD. https:\/\/www.hcup-us.ahrq.gov\/reports\/statbriefs\/sb186-Operating-Room-Procedures-United-States-2012.pdf. 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