P0711 - Cannabinoid Use Is Associated With Better Hospital Outcome in Patients With Cirrhosis: A Study Based on Nationwide Inpatient Sample

Rajesh Essrani, MD¹, Muhammad Usman Zafar, MD¹, Zahid I. Tarar, MD², Umer Farooq, MD³, Jiten Kothadia, MD^4
1Lehigh Valley Health Network, Allentown, PA; ²University of Missouri School of Medicine, Columbia, MO; ³Loyola Medicine/MacNeal Hospital, Berwyn, IL; ⁴University of Tennessee Health Science Center, Memphis, TN

Introduction: The cannabinoid is becoming legal in an increasing number of states in the USA for both medical and recreational use. However, substantial controversy still exists about the public health consequence of these changes. Conflicting evidence exists regarding the effect of cannabinoid use on patients with cirrhosis. Its impact on hospitalized due cirrhosis has remained unknown. We aim to evaluate the effect of cannabinoid use on patients with cirrhosis from Nationwide Inpatient Sample (NIS).

Methods: Nationwide inpatient sample (NIS) was analyzed from 2017 to 2018 for patients (age >18 years) with a primary diagnosis of LC (N= 410825) and a secondary diagnosis of cannabinoid use (N=12325). The length of stay (LOS) and in-hospital mortality were compared in LC patients with and without cannabinoid use. Multiple confounders like Charlson comorbidity index (CCI), coronary artery disease, opioid use, anxiety, depression, congestive heart failure, smoking, hyperlipidemia, alcohol intake, diabetes mellitus, myocardial infarction, chronic kidney disease, gender, age, race, hospital region, hospital teaching status, hospital bed size, and patient’s economic status were included to adjust for biases. The univariate and multivariate logistic regression analysis was used in STAT MP 16.1 to measure mortality and length of stay.

Results: Cannabinoids decreases odds of mortality in LC patients irrespective of all the confounders (OR) 0.70, p = 0.005, 95% Confidence Interval (CI) 0.55-0.90. Factors contributing to high odds of mortality include higher Charlson index, alcohol intake, older age, patients admitted on weekends, teaching hospital, and larger hospital. Cannabinoids decreases LOS by 0.36 days independent of all the confounders (p = 0.000, 95% CI 0.68 – 1.14) (Table 1). Factors contributing to high LOS include higher Charlson index, anxiety, congestive heart failure, chronic kidney disease, and female gender.

Discussion: Cannabinoid use is associated with better hospital outcomes in patients with cirrhosis. Future prospective studies are needed to draw conclusions regarding a clear therapeutic role of cannabis in patients with cirrhosis.

Mortality
Variable (Mortality)	Odds Ratio	p-Value	95% Confidence Interval
Cannabinoid	0.70	0.005	0.55	0.90
Charlson Index	1.16	0.000	1.14	1.18
History of Coronary Artery Disease	0.88	0.049	0.78	1.00
Opioid Use	0.70	0.007	0.55	0.91
Anxiety	0.82	0.000	0.73	0.91
Depression	0.74	0.000	0.66	0.83
History of Congestive Heart Failure	1.00	0.941	0.90	1.10
Smoking	0.73	0.000	0.67	0.80
Hyperlipidemia	0.74	0.000	0.66	0.82
Alcohol Intake	1.15	0.000	1.07	1.24
Diabetes Mellitus	0.55	0.000	0.49	0.62
Myocardial Infarction	0.74	0.008	0.60	0.93
Chronic Kidney Disease	0.74	0.000	0.67	0.82
Weekend Admission	1.12	0.003	1.04	1.21
Age	1.01	0.000	1.01	1.02
Female	0.92	0.011	0.85	0.98
Hospital Teaching Status	1.11	0.007	1.03	1.20
Hospital Bedside (compared to small)
Medium	1.08	0.132	0.98	1.21
Large	1.17	0.001	1.06	1.29
Length of Stay
Variable (Length of Stay)	Coefficient	p-Value	95% Confidence Interval
Cannabinoid	-0.36	0.013	-0.65	-0.08
Charlson Index	0.29	0.000	0.26	0.32
History of Coronary Artery Disease	-0.31	0.000	-0.46	-0.17
Opioid Use	0.20	0.209	-0.11	0.50
Anxiety	0.23	0.002	0.09	0.37
Depression	0.13	0.065	-0.01	0.27
History of Congestive Heart Failure	0.45	0.000	0.26	0.64
Smoking	-0.67	0.000	-0.78	-0.56
Hyperlipidemia	-0.50	0.000	-0.62	-0.38
Alcohol Intake	-0.06	0.272	-0.18	0.05
Diabetes Mellitus	-1.10	0.000	-1.21	-0.98
Myocardial Infarction	-0.87	0.000	-1.10	-0.64
Chronic Kidney Disease	0.32	0.000	0.14	0.50
Weekend Admission	-0.06	0.266	-0.17	0.05
Age	-0.02	0.000	-0.02	-0.01
Female	0.18	0.000	0.08	0.28
Hospital Teaching Status	1.12	0.000	0.98	1.25
Hospital Bedside (compared to small)
Medium	0.53	0.000	0.36	0.69
Large	1.38	0.000	1.21	1.54

Table: Table 1: Mortality and Length of Stay.


Disclosures:
Rajesh Essrani indicated no relevant financial relationships.
Muhammad Usman Zafar indicated no relevant financial relationships.
Zahid Tarar indicated no relevant financial relationships.
Umer Farooq indicated no relevant financial relationships.
Jiten Kothadia indicated no relevant financial relationships.


Rajesh Essrani, MD¹, Muhammad Usman Zafar, MD¹, Zahid I. Tarar, MD², Umer Farooq, MD³, Jiten Kothadia, MD⁴. P0711 - Cannabinoid Use Is Associated With Better Hospital Outcome in Patients With Cirrhosis: A Study Based on Nationwide Inpatient Sample, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.