Abstract 13858: The Epidemiological Characteristics & Outcome Trend of Cannabis Abuse Among Stroke Hospitalizations in the United States - A Nationwide Study

Abstract

Background: With the legalization of cannabis in many states for medical or recreational purposes, cannabis utilization has been increased to treat various health concerns. However, little is known about the prevalence of cannabis abuse and outcome trend among acute ischemic stroke (AIS) patients. This study examines the epidemiological characteristics and outcome trend of cannabis abuse among adults with AIS hospitalizations in the USA. Methods: We performed a population-based retrospective analysis of the Nationwide Inpatient Sample over year from 2003 to 2017 in adult hospitalizations for AIS to compare the outcomes [death, risk mortality & discharge disposition (short-term hospital / skilled nursing home/home health care)] in cannabis abusers using ICD 9 & 10 codes. We performed weighted analyses using chi-square, t-test, and Cochran-Armitage trend test. Results: Amongst the total of 5,690,773 AIS hospitalizations, 50,895 (0.89%) cannabis users were identified from 2003 to 2017. The prevalence trend of cannabis abuse has increased among stroke hospitalizations (2003: 0.22% to 2017:1.64%; p-trend < 0.0001). The cannabis abuse was higher among the younger to middle age compared to older aged stroke hospitalization (<50 year: 3.89% vs 50-75 year: 1.09% vs >75 year: 0.02%; p <0.0001). Cannabis abuse was more prevalent among the male (1.32% vs female: 0.50%), Black (2.29% vs White: 0.61%; p<0.0001). The cannabis abusers had lower median household income (1.39% vs higher income:0.44%), medicaid insurance (3.61% vs medicare: 0.31%), highly prevalent in midwest (1.05% vs northeast: 0.57%; p<0.0001). There was also increased trend in mortality (2003: 0.38% to 2017: 0.97%), extreme/major likelihood of dying (2003: 0.21% to 2017: 1.22%), extreme/major loss of function (2003: 0.19% to 2017: 1.52%), discharge to non-home (2003: 0.14% to 2017: 1.25%; p-trend<0.0001) among cannabis abusers following stroke hospitalizations. Conclusion: This study identified a higher prevalence of abuse, abuse-related poor outcomes, and higher stroke-related mortality among stroke survivors. Cannabis use in patients with neurovascular insults has raised safety concerns, and more long-term research is needed to determine its risks and benefits in stroke patients.