840 Patient Characteristics and Outcomes Associated With Cannabis Abuse or Dependence Among Hospitalized Patients With IBD: A U.S. Time-Trend Analysis and Population-Based Cohort Study

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INTRODUCTION: Cannabis is a commonly used yet restricted substance with potential anti-inflammatory and analgesic properties. Patients with inflammatory bowel disease (IBD) use cannabis specifically for symptom relief, however its safety and efficacy in ulcerative colitis (UC) and Crohn’s disease (CD) are poorly characterized. Among hospitalized patients with IBD, temporal trends of heavy cannabis use and its effects on hospitalization outcomes are unclear. We therefore attempted to assess yearly trends in cannabis abuse or dependence (CAoD) and associated hospitalization outcomes among hospitalized patients with IBD. METHODS: This was a retrospective population-based cohort study utilizing the Healthcare Utilization Project (HCUP) National Inpatient Sample (NIS) database from 2005 to 2014. We performed a time-trend analysis of CAoD among IBD patients using International Classification of Disease, ninth revision clinical modification (ICD-9-CM) diagnosis codes for cannabis dependence, non-dependent cannabis abuse, CD, and UC, in any diagnosis position. For a multivariable analysis of the effect of CAoD on hospitalization outcomes, IBD-specific hospitalizations were identified by a primary diagnosis of IBD or a secondary diagnosis of IBD with a primary diagnosis of an IBD-related complication. Multivariable linear or logistic regression was used to assess the association of CAoD on hospital length of stay (LOS), total charges, in-hospital mortality, and IBD surgery. The weighted NIS sample was used for all analyses. RESULTS: Between 2005 and 2014, we identified 2,788,246 discharges with a diagnosis of IBD and 1,049,837 discharges for IBD-specific hospitalizations, among which 10,293 (1.0%) were associated with CAoD. Among those with CAoD, 74.9% had CD (vs. 25.1% UC, P < 0.01), 64.9% were male, 56.9% were cigarette smokers, and 38.6% were in the 21-30 y age group (Table 1). There was an average annual increase of 9.1% (P < 0.01) for CAoD among hospitalized IBD patients from 2005 to 2014 (Figure 1). After multivariable regression, CAoD was independently associated with decreased LOS (-0.4 d; 95% CI -0.6–-0.2 d) and odds of IBD surgery (OR 0.8, 95% CI 0.7–0.9) (Table 2). There was no association with total charges and no IBD patients with CAoD died during their hospitalization. CONCLUSION: CAoD may be associated with decreased LOS and odds of IBD-related surgery among hospitalized IBD patients. Further research is needed to assess the impact of heavy cannabis use on long-term outcomes in patients with IBD.