Nationwide outcomes of cardiac surgery in patients with cannabis use disorder

Q: What are the key findings of this study?

Cannabis use disorder was associated with significantly lower in-hospital mortality (1.8% vs 2.7%, p<0.001) and similar overall complication rates compared to no cannabis use disorder.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Cardiovascular surgery (n=846837). Intervention: Cannabis use disorder (CUD) vs. No cannabis use disorder. Primary outcome: In-hospital mortality (p=<0.001).

Q: What question did this study set out to answer?

To evaluate the in-hospital outcomes, complication rates, and 90-day readmissions of patients with cannabis use disorder undergoing cardiovascular surgery.

Franklin H. Lee; Rashed Mahboubi; Samantha Xu; Jean-Luc A. Maigrot; Crystal An; Guangjin Zhou; Jose L. Diz Ferre; Siran M. Koroukian; Aaron J. Weiss; Edward G. Soltesz

doi:10.1186/s13019-025-03755-6

January 17, 2026Journal of Cardiothoracic SurgeryOpen Access

Nationwide outcomes of cardiac surgery in patients with cannabis use disorder

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Key result

Cannabis use disorder linked to ~1-point lower in-hospital mortality with similar overall complication rates.

P<0.001
n=846,837

Key Points

To evaluate the in-hospital outcomes, complication rates, and 90-day readmissions of patients with cannabis use disorder undergoing cardiovascular surgery.
Retrospective analysis of 846,837 hospitalizations for cardiac surgery between 2016 and 2018, identifying 11,724 (1.4%) patients with documented cannabis abuse or dependence.
Propensity score matching was used to balance baseline characteristics, yielding 6,220 well-matched pairs of hospitalizations with and without cannabis use disorder.
Propensity-matched analysis demonstrated no significant difference in overall complications between patients with and without cannabis use disorder (65% vs. 65%, P=.66).
Hospital mortality was lower among matched cannabis use disorder patients (1.8% vs. 2.7%; P<.001), and readmissions at 90 days postoperatively were identical (21% vs. 21%, P=.73).
Cannabis use disorder was strongly associated with polysubstance abuse, including tobacco use (nearly 50%), alcohol abuse (18%), cocaine/stimulants abuse (17%), and opioid use disorder (7.5%).

Study Design

Type

Cohort (n=846,837)

Multicenter

Yes

PICO

P

Population

846,837 adults undergoing major cardiovascular surgery, including 11,724 with cannabis use disorder, evaluated for in-hospital morbidity and mortality using a national readmissions database.

E

Exposure / Comparator

Cannabis use disorder (CUD) vs No cannabis use disorder

O

Primary Outcome

In-hospital mortality, p=<0.001

Main Result

Absolute Event Rate: 1.8% vs 2.7%

p-value: p=<0.001

Limitations

Retrospective study using administrative data with potential for miscoding and overcoding
Lack of clinical granularity afforded by single-center databases
Likely underrepresents the true number of patients with CUD due to infrequent screening and inconsistent patient disclosure

Implication

Nationwide outcomes reveal challenges in cardiac surgery for patients with cannabis use disorder, suggesting treatment needs.

Abstract

Patients with CUD are a vulnerable population with concomitant smoking, opioid abuse, cocaine abuse, and alcohol abuse that deserves treatment while undergoing cardiovascular surgery.

Discussion

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Cite This Study

Lee et al. (2026) conducted a cohort in Cardiovascular surgery (n=846,837). Cannabis use disorder (CUD) vs. No cannabis use disorder was evaluated on In-hospital mortality (p=<0.001). Cannabis use disorder was associated with significantly lower in-hospital mortality (1.8% vs 2.7%, p<0.001) and similar overall complication rates compared to no cannabis use disorder.

synapsesocial.com/papers/696f1a849e64f732b51eeb92 https://doi.org/10.1186/s13019-025-03755-6

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Nationwide outcomes of cardiac surgery in patients with cannabis use disorder

Key Points

Study Design

PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

Nationwide outcomes of cardiac surgery in patients with cannabis use disorder

Key Points

Study Design

PICO

Main Result

Limitations

Implication

Abstract

Discussion

Cite This Study

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