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Patient Marijuana Use Reporting Bias: a review of surgical disclosures
Henry Huson MD, Kiersten C. Woodyard, MPH, Michael Zappa BS, Ermina Lee BS, Ryan Gobble MD
University of Cincinnati
2023-02-09
Presenter: Henry Huson
Affidavit:
Submitted Research is the original work of the resident submitting
Director Name: Ann Schwentker MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background: Marijuana use is legalized for medicinal use in 37 states and recreational use in 21 states. Ongoing investigations of marijuana health impact require patient disclosure to healthcare providers, but patients may fear stigma or rejection from surgeons performing non-emergent procedures.
Methods: A retrospective chart review was performed for patients who received breast reductions from 2013-2022. Data collection included demographics, comorbidities, perioperative data, outcomes, and chart documentation of regular marijuana use. Patients were considered to have peri-operative marijuana use if regular use was clinically documented within a year of surgery. Exclusion criteria included tobacco use or breast cancer history. Statistical analysis included t-tests and Chi-squared tests.
Results: 413 patients underwent breast reductions over 9 years. 53 (12.8%) had regular marijuana use clinically documented within a year of surgery. 14 of 53 (26.4%) disclosed marijuana use to the surgeon performing their breast reduction. 39 disclosed use to non-surgeon providers, including pre-procedure anesthesia (15), obstetrics or emergency (14), and primary care or other provider. Patients had higher disclosure to surgeons after marijuana sale became operationalized instate (p=0.034), but disclosure did not increase after legalization, before instate sale. Patients using marijuana without disclosure to their surgeon demonstrated a higher pooled complication rate than patients who disclosed marijuana use to their surgeon (p=0.012).
Conclusions: Marijuana use disclosure to surgeons was lower than disclosure to other healthcare providers, predominantly specialties which emphasize social history screening. While patients may fear stigma from surgeons, it is likely that surgeons are not appropriately screening for marijuana use.
