P2234 - Cannabis Use Is Associated With an Increased Risk of Intestinal Obstruction in Patients Hospitalized With Diverticulitis

Daniel Rim, MD¹, Alexander Kaye, MD, MBA¹, Siddharth Verma, DO^2
1Rutgers New Jersey Medical School, Newark, NJ; ²East Orange VA Hospital, East Orange, NJ

Introduction: Diverticulitis is a common cause of hospitalization. The use of substances such as tobacco and alcohol can predispose patients to diverticulitis, and smoking is also associated with an increased risk of diverticulitis complications. Cannabis availability is increasing in the USA, but there is a lack of data on the effects of cannabis use on the outcomes of diverticulitis. Thus, we investigated the effects of cannabis use on diverticulitis outcomes.

Methods: Patients hospitalized with diverticulitis from the National Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality 2014 were selected. Diagnoses were identified by using ICD-9 CM codes. Patient demographics and outcomes of diverticulitis were compared between the groups with and without a history of cannabis use. The outcomes of interest were inpatient mortality, length of stay, total hospital charge, hypotension/shock, intestinal abscess, intestinal obstruction, intestinal fistula, intestinal perforation, and colectomy. Chi-squared tests and independent t-tests were used to compare proportions and means respectively. Multivariate logistic regression analysis was performed to determine if cannabis use is an independent predictor for the outcomes, adjusting for age, sex, race, and the Charlson Comorbidity Index.

Results: Among 48,214 patients with diverticulitis identified in the study, 447 patients had a history of cannabis use. Among patients hospitalized with diverticulitis, those with cannabis use were younger (45.8 vs 60.6, p < 0.05), less likely to be female (25.5% vs. 58.5%, p < 0.05), less likely to be White (60.1% vs. 77.3%, p < 0.05), had lower Charlson Comorbidity Index (1.1 vs. 2.5, p < 0.05), and had shorter length of stay (4.3 days vs. 4.7 days, p < 0.05). There were no statistically significant differences in inpatient mortality and total hospital charge. After adjusting for age, sex, race, and the Charlson Comorbidity Index, cannabis use was an independent risk factor for intestinal obstruction (OR 1.69, 95% CI: 1.05-2.73, p < 0.05). However, there were no statistically significant differences in other outcomes.

Discussion: Our study indicates that patients hospitalized with diverticulitis with a history of cannabis use are more likely to have an intestinal obstruction. Inhibition of gastrointestinal motility by cannabis in the setting of diverticular inflammation may explain this finding.

Outcomes	Adjusted Odds Ratio*	95% Confidence Interval	P-value
Colectomy	0.83	0.61-1.13	0.23
Intestinal abscess	1.20	0.95-1.53	0.13
Intestinal obstruction	1.69	1.05-2.73	< 0.05

Table: *Adjusted for age, sex, race, and the Charlson Comorbidity Index. Analysis of hypotension/shock, intestinal fistula, and intestinal perforation was not performed due to small sample sizes.


Disclosures:
Daniel Rim indicated no relevant financial relationships.
Alexander Kaye indicated no relevant financial relationships.
Siddharth Verma indicated no relevant financial relationships.


Daniel Rim, MD¹, Alexander Kaye, MD, MBA¹, Siddharth Verma, DO². P2234 - Cannabis Use Is Associated With an Increased Risk of Intestinal Obstruction in Patients Hospitalized With Diverticulitis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.