From Notes to Knowledge: Deciphering Perioperative Risky Substance Use through Natural Language Processing

Patients commonly use substances that pose risks to their health such as tobacco, alcohol, and other drugs in the perioperative period, with important implications for their anesthetic care.In recent surveys of patients presenting for surgery, more than 2 in 5 patients evaluated in the preoperative clinical setting endorsed some level of substance use that poses surgical risk, including use of cannabis products.1 Clinically, it can be challenging to consistently assess use of different types of substances in an efficient yet reliable manner.Cannabis use presents a complex yet increasingly prevalent practice reported by patients.Most Americans now live in states that allow medical use of cannabis as a treatment for conditions including chronic pain, and many states have legalized recreational cannabis use.Perhaps unsurprisingly, more Americans report daily use of cannabis than daily alcohol consumption.2 This change in population-level behavior is likely to translate to individual patients who present for surgery.The recent surge in cannabis use has exposed significant gaps in our understanding of how pre-surgical cannabis consumption affects anesthesia management and patient care.