Abstract：
BACKGROUND: Cannabis use is increasing among older adults, but its impact on postoperative pain outcomes remains unclear in this population. We examined the association between cannabis use and postoperative pain levels and opioid doses within 24 hours of surgery.
METHODS: We conducted a propensity score-matched retrospective cohort study using electronic health records data of 22 476 older surgical patients with at least 24-hour hospital stays at University of Florida Health between 2018 and 2020. Of the original cohort, 2577 patients were eligible for propensity-score matching (1:3 cannabis user: non-user). Cannabis use status was determined via natural language processing of clinical notes within 60 days of surgery and structured data. The primary outcomes were average Defense and Veterans Pain Rating Scale (DVPRS) score and total oral morphine equivalents (OME) within 24 hours of surgery.
RESULTS: 504 patients were included (126 cannabis users and 378 non-users). The median (IQR) age was 69 (65-72) years; 295 (58.53%) were male, and 442 (87.70%) were non-Hispanic white. Baseline characteristics were well balanced. Cannabis users had significantly higher average DVPRS scores (median (IQR): 4.68 (2.71-5.96) vs 3.88 (2.33, 5.17); difference=0.80; 95% confidence limit (CL), 0.19 to 1.36; p=0.01) and total OME (median (IQR): 42.50 (15.00-60.00) mg vs 30.00 (7.50-60.00) mg; difference=12.5 mg; 95% CL, 3.80 mg to 21.20 mg; p=0.02) than non-users within 24 hours of surgery.
CONCLUSIONS: This study showed that cannabis use in older adults was associated with increased postoperative pain levels and opioid doses.
METHODS: We conducted a propensity score-matched retrospective cohort study using electronic health records data of 22 476 older surgical patients with at least 24-hour hospital stays at University of Florida Health between 2018 and 2020. Of the original cohort, 2577 patients were eligible for propensity-score matching (1:3 cannabis user: non-user). Cannabis use status was determined via natural language processing of clinical notes within 60 days of surgery and structured data. The primary outcomes were average Defense and Veterans Pain Rating Scale (DVPRS) score and total oral morphine equivalents (OME) within 24 hours of surgery.
RESULTS: 504 patients were included (126 cannabis users and 378 non-users). The median (IQR) age was 69 (65-72) years; 295 (58.53%) were male, and 442 (87.70%) were non-Hispanic white. Baseline characteristics were well balanced. Cannabis users had significantly higher average DVPRS scores (median (IQR): 4.68 (2.71-5.96) vs 3.88 (2.33, 5.17); difference=0.80; 95% confidence limit (CL), 0.19 to 1.36; p=0.01) and total OME (median (IQR): 42.50 (15.00-60.00) mg vs 30.00 (7.50-60.00) mg; difference=12.5 mg; 95% CL, 3.80 mg to 21.20 mg; p=0.02) than non-users within 24 hours of surgery.
CONCLUSIONS: This study showed that cannabis use in older adults was associated with increased postoperative pain levels and opioid doses.
摘要：
背景：老年人使用大麻正在增加，但其对该人群术后疼痛结局的影响尚不清楚.我们检查了手术后24小时内使用大麻与术后疼痛水平和阿片类药物剂量之间的关系。
方法：我们使用2018年至2020年在佛罗里达健康大学住院至少24小时的22476例老年手术患者的电子健康记录数据进行了倾向评分匹配的回顾性队列研究。在最初的队列中，2577名患者符合倾向评分匹配（1：3大麻使用者：非使用者）。通过手术后60天内的临床笔记的自然语言处理和结构化数据来确定大麻的使用状态。主要结果是手术后24小时内的平均防御和退伍军人疼痛评定量表（DVPRS）评分和总口服吗啡当量（OME）。
结果：包括504名患者（126名大麻使用者和378名非使用者）。中位年龄（IQR）为69（65-72）岁；295（58.53%）为男性，和442（87.70%）是非西班牙裔白人。基线特征平衡良好。大麻使用者的平均DVPRS得分明显较高（中位数（IQR）：4.68（2.71-5.96）vs3.88（2.33，5.17）；差异=0.80；95％置信限（CL），0.19至1.36；p=0.01）和总OME（中位数（IQR）：42.50（15.00-60.00）mgvs30.00（7.50-60.00）mg；差异=12.5mg；95％CL，3.80mg至21.20mg；p=0.02）在手术后24小时内与非使用者相比。
结论：这项研究表明，老年人使用大麻与术后疼痛水平和阿片类药物剂量增加有关。
方法：我们使用2018年至2020年在佛罗里达健康大学住院至少24小时的22476例老年手术患者的电子健康记录数据进行了倾向评分匹配的回顾性队列研究。在最初的队列中，2577名患者符合倾向评分匹配（1：3大麻使用者：非使用者）。通过手术后60天内的临床笔记的自然语言处理和结构化数据来确定大麻的使用状态。主要结果是手术后24小时内的平均防御和退伍军人疼痛评定量表（DVPRS）评分和总口服吗啡当量（OME）。
结果：包括504名患者（126名大麻使用者和378名非使用者）。中位年龄（IQR）为69（65-72）岁；295（58.53%）为男性，和442（87.70%）是非西班牙裔白人。基线特征平衡良好。大麻使用者的平均DVPRS得分明显较高（中位数（IQR）：4.68（2.71-5.96）vs3.88（2.33，5.17）；差异=0.80；95％置信限（CL），0.19至1.36；p=0.01）和总OME（中位数（IQR）：42.50（15.00-60.00）mgvs30.00（7.50-60.00）mg；差异=12.5mg；95％CL，3.80mg至21.20mg；p=0.02）在手术后24小时内与非使用者相比。
结论：这项研究表明，老年人使用大麻与术后疼痛水平和阿片类药物剂量增加有关。
