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Monday Poster Session

Category: GI Bleeding

P2047 - Impact of Cannabis Use Disorder on In-Hospital Mortality in Geriatric Population Hospitalized With Gastrointestinal Hemorrhage: A National Population Based Analysis

Monday, October 23, 2023
10:30 AM – 4:15 PM PT
Location: Exhibit Hall
Ali Tariq Alvi, MD1, Syed Mohammad Moosi Raza, MBBS2, Thanmai Reddy Thugu, MBBS3, Samridhi Lakhanpal, MBBS4, Mohammed Mustafa Nayeem, MD5, Anusha Parisapogu, MBBS6, Masoud Amini, MD7, Sushrut Sarma Palepu, MBBS8, Trishna Acherjee, 9, Siddharth Arjun. Atwal, MBBS10, Rupak Desai, MBBS11
1HCA Florida Westside Hospital, Plantation, FL; 2Fortis Escorts Heart Institute, New Delhi, Delhi, India; 3Sri Padmavathi Medical College for Women, SVIMS, Tirupathi, Andhra Pradesh, India; 4Saint Peter's University Hospital, New Brunswick, NJ; 5Parkview Medical Center, Peublo, CO; 6Mayo Clinic, Rochester, MN; 7Mount Sinai Services-NYC Health+Hospitals/Queens, New York, NY; 8Kasturba Medical College, Udupi, Karnataka, India; 9Reading Hospital Tower Health, Reading, PA; 10Civil Hospital Jalandhar, Jalandhar, Punjab, India; 11Outcomes Research, Atlanta, GA

Introduction: There is some evidence suggesting cannabis to induce vascular spasm in the gastrointestinal vessels by rapidly altering neurotransmitter release from nerve terminals, which could provide beneficial effects in high-risk patients. However, the impact of cannabis use on gastrointestinal bleeding remains unknown. In this study, we aimed to assess the burden and impact of cannabis use disorder (CUD) on in-hospital mortality in geriatric population ( > 65 years) hospitalized with Gastrointestinal Hemorrhage (GIH).

Methods: The National Inpatient Sample (2019) with relevant ICD-10-CM codes were used to identify patients with GIH and Cannabis Use Disorder (CUD). We compared demographics, comorbidities, and outcomes of patients with GIH with vs without CUD (CUD+ vs CUD-). Primary endpoint was all-cause mortality. Multivariable regression analyses were performed adjusting for demographics, hospital-level characteristics, and relevant comorbidities

Results: A total of 673,465 elderly patients with GIH were identified in our study, of which 2485 (0.4%) had a reported CUD. The CUD cohort had median age of 69 (IQR 67-72), often consisted of male (72.9%), white (65.5%) patients belonging to the lowest median household income quartile (37%), medicare enrollees of elderly hospitalized admissions. The CUD cohort had lower rates of certain cardiovascular comorbidities including complicated hypertension, diabetes, hyperlipidemia, obesity, but higher rates of chronic pulmonary disease, peripheral vascular disease, prior MI, and drug abuse. A multivariable analysis after adjusting for all potential covariates showed lower odds of all-cause mortality with an aOR of 0.50 (CI 0.26-0.93, p = 0.029). Majority of those admissions had a routine disposition with a median hospital stay of 4 days and costs up to 49,406 USD.

Discussion: Our study showed lower odds of all-cause mortality in elderly hospitalized patients with GIH. While there is association between cannabis use and gastrointestinal physiology, the specific relationship with gastrointestinal bleeding requires further investigation. This paves the way for conducting further observational studies and clinical trials in order to explore use of cannabis in potentially high-risk elderly patients.

 

Variable

 

Total Admissions with GIH  

p-value

CUD-

CUD+

Age (years) at admission

Median [IQR]

69

69

0.090

Sex

Male

70.6%

72.9%

0.081

Female

29.4%

27.1%

Race

White

65.1%

65.5%

0.064

Black

22.4%

23.3%

Hispanic

6.9%

6.1%

Asian or Pacific Islander

2.2%

1.2%

Primary Expected Payer

Medicare

84.3%

85.3%

< 0.001

Medicaid

2.9%

2.2%

Private including HMO

10.4%

8.4%

Self -pay

 

0.6%

Others

2.0%

3.5%

Patient Disposition

Routine

54.5%

58.8%

< 0.001

Transfer to short term hospital

2.4%

2.2%

Other transfers SNF, ICF

20.4%

16.5%

Home healthcare

14.1%

14.9%

Non-Elective Admission

 

95.7%

95.1%

0.306

Elective Admission

 

4.3%

4.9%

Comorbidities

    

Alcohol Abuse

 

12.2%

26.7%

< 0.001

Cancer

 

15.7%

13.3%

0.015

Hypothyroidism

 

14.1%

10.8%

0.001

Prior Transient Ischemic Attack/Stroke

 

6.1%

9.2%

< 0.001

Depression 

 

13.7%

18.4%

< 0.001

Chronic Pulmonary Disease

 

30.4%

34.9%

0.001

Opioid Related Disorder

 

3.1%

4.9%

0.001

Obesity

 

16.9%

10.6%

< 0.001

HTN Uncomplicated

 

36.5%

40.6%

0.003

HTN Complicated

 

37.3%

34.7%

0.053

Diabetes with Chronic Complications

 

28.0%

21.4%

< 0.001

Diabetes without Chronic Complications

 

12.4%

9.0%

< 0.001

AIDS

 

0.8%

1.8%

0.002

Metastatic Cancer

 

8.0%

4.7%

< 0.001

Drug Abuse

 

3.9%

38.0%

< 0.001

Region of Hospital

North-East

16.7%

15.1%

< 0.001

 

Mid-West

19.8%

19.6%

 

South

45.7%

32.0%

 

West

17.8%

33.3%

In-hospital Outcomes

    

All-Cause Mortality

 

6.5%

3.5%

< 0.001

Length of Stay (days)

Median [IQR]

4

4

0.002

Total Charges (USD)

Median [IQR]

45812

49406

0.246

In Hospital All-Cause Mortality with or without Cannabis Use Disorder

 

CUD -

CUD+

P value

Males

6.4%

3.9%

0.001

Females 

6.9%

2.3%

< 0.001

White

6.3%

3.4%

< 0.001

Black

7.3%

 

5.3%

0.165

Outcomes 

Adjusted OR

95% CI Lower limit

95% CI Upper limit

P value

All -cause Mortality

0.50

0.26

0.93

0.029



Disclosures:
Ali Tariq Alvi indicated no relevant financial relationships.
Syed Mohammad Moosi Raza indicated no relevant financial relationships.
Thanmai Reddy Thugu indicated no relevant financial relationships.
Samridhi Lakhanpal indicated no relevant financial relationships.
Mohammed Mustafa Nayeem indicated no relevant financial relationships.
Anusha Parisapogu indicated no relevant financial relationships.
Masoud Amini indicated no relevant financial relationships.
Sushrut Sarma Palepu indicated no relevant financial relationships.
Trishna Acherjee indicated no relevant financial relationships.
Siddharth Atwal indicated no relevant financial relationships.
Rupak Desai indicated no relevant financial relationships.


Ali Tariq Alvi, MD1, Syed Mohammad Moosi Raza, MBBS2, Thanmai Reddy Thugu, MBBS3, Samridhi Lakhanpal, MBBS4, Mohammed Mustafa Nayeem, MD5, Anusha Parisapogu, MBBS6, Masoud Amini, MD7, Sushrut Sarma Palepu, MBBS8, Trishna Acherjee, 9, Siddharth Arjun. Atwal, MBBS10, Rupak Desai, MBBS11. P2047 - Impact of Cannabis Use Disorder on In-Hospital Mortality in Geriatric Population Hospitalized With Gastrointestinal Hemorrhage: A National Population Based Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.