Thomas R. McCarty, MD1, Fouad Chouairi, BS2, Prabin Sharma, MD3, Kelly E. Hathorn, MD1, Thiruvengadam Muniraj, MD, PhD2, Christopher C. Thompson, MD, MSc1; 1Brigham & Women's Hospital, Boston, MA; 2Yale University, School of Medicine, New Haven, CT; 3Bridgeport Hospital, Yale University School of Medicine, Bridgeport, CT
Introduction: Chronic Pancreatitis (CP) may result in persistent, debilitating abdominal pain and pancreatic insufficiency. Recent literature suggests cannabis may be an effective adjunctive therapy for the treatment of pain associated with CP; however, there remains a paucity of epidemiologic data. As such, along with the increase in legalization of cannabis across the United States, we aimed to investigate the impact of cannabis use on relevant clinical outcomes among hospitalized patients with CP. Methods: Patients with a diagnosis of CP were reviewed from the Nationwide Inpatient Sample (NIS) database between 2008 and 2014. CP was identified by International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) codes with patients classified with or without a co-diagnosis of cannabis use disorder. Measured variables including age, race/ethnicity, comorbidities, hospital type, hospital region, insurance payer type, median household income quartile, length of hospital stay, total cost, and mortality were compared between cohorts using chi-squared and ANOVA. Annual trends over the study period were also evaluated. Results: A total of 215,520 patients with CP were analyzed (n=5,947 patients with concomitant cannabis use disorder). Baseline patient and hospital characteristics are highlighted in Table 1. Patients with cannabis use disorder and CP were more likely to be younger and male gender compared to non-users [(43.4±10.8 vs 51.8±15.3 years;P< 0.001) and (70.5% vs 54.2%;P< 0.001), respectively]. Cannabis use was also associated with a lower median household income as well as Medicaid payor status (all P< 0.001). Despite differences in comorbidities, length of stay (4.3±4.1 vs 5.8±6.9 days;P< 0.001), hospital costs ($27082±24361 vs $39044±62372;P< 0.001), and mortality (0.3% vs 1.5%;P< 0.001) were decreased for patients with CP and cannabis use compared to non-users. Furthermore, the incidence of cannabis use among patients with CP significantly increased over the study period from 9.3% in 2008 to 17.9% in 2014 – average increase of 1.43% per year (Ptrend< 0.001). Discussion: Based on this nationwide analysis, cannabis use among patients with CP has increased over time and was associated with a reduction in hospital length of stay, lower hospitalization costs, and decreased mortality. Future studies to examine the nature of this relationship are needed.
Table 1: Baseline Patient and Hospital Characteristics of Patients with Chronic Pancreatitis: Patients With and Without Cannabis Use Disorder
Table 2: Annual Trends of Cannabis Use and Chronic Pancreatitis Over Study Period
Disclosures: Thomas McCarty indicated no relevant financial relationships. Fouad Chouairi indicated no relevant financial relationships. Prabin Sharma indicated no relevant financial relationships. Kelly Hathorn indicated no relevant financial relationships. Thiruvengadam Muniraj indicated no relevant financial relationships. Christopher Thompson: Apollo Endosurgery – Consultant, Grant/Research Support. Aspire Bariatrics – Grant/Research Support. BlueFlame Healthcare Venture Fund – Other Financial or Material Support, General Partner. Boston Scientific – Consultant. Covidien/Medtronic – Consultant. EnVision Endoscopy – Other Financial or Material Support, Board Member. Fractyl – Consultant, Other Financial or Material Support, Advisory Board Member. GI Dynamics – Consultant, Grant/Research Support. GI Windows – Stockholder/Ownership Interest (excluding diversified mutual funds). Olympus/Spiration – Consultant, Grant/Research Support. Spatz – Grant/Research Support. USGI Medical – Consultant, Grant/Research Support, Other Financial or Material Support, Advisory Board Member.