Abstract 139: Higher Frequency And Odds Of Recurrent/subsequent Stroke Admissions In Young (18-44 Years) Patients With Prior Stroke/transient Ischemic Attack With Versus Without Cannabis Use Disorder: A Nationwide Inpatient Analysis

Abstract

Background: Cannabis use disorder (CUD) is more prevalent in the young population and cannabis use has been linked to an increased risk of first-time stroke or transient ischemic attack (TIA). Prevalence and risk of recurrent stroke in patients with prior stroke/TIA in cannabis users are not clearly established. Methods: Using weighted data from the National Inpatient Sample (2015 October-2017 December) and pertinent ICD-10 codes, we identified hospitalizations among young (18-44 years) patients with prior history of stroke/TIA grouped into those with CUD+ and those without (CUD-). We compared the frequency (with disparities based on gender, race, hospital region and median household income) and odds of subsequent/recurrent stroke in young adults (18-44 years) with vs without cannabis use (CUD+ vs. CUD-) and prior history of stroke/TIA. Results: Young adult hospitalizations with prior stroke/TIA were 4690 in the CUD+ arm, and 156700 in CUD- arm (median age 37 years in both cohorts). The CUD+ cohort often consisted of males (55.2% vs. 40.2%), African Americans (44.6% vs. 37.2%), and patients with higher rates of concomitant substance abuse, COPD, depression and psychoses, and a lower rate of cardiovascular comorbidities compared to the CUD- cohort (p<0.001) [Table 1a]. The CUD+ arm had considerably higher rate (6.9 vs 5.4%) [Table 1b] and adjusted odds (aOR 1.48, 95 CI 1.28-1.71, p<0.001) of recurrent stroke than CUD- arm [Table 1c] . On subgroup comparison, admission among male (7.7% vs. 5.9%), white (6.6% vs. 5.1%), African American (8.0% vs. 5.2%), and admissions in low household income quartile (7.7% vs. 5.5%) patients, Northeast (6.1% vs. 4.4%) and Southern (7.6% vs. 5.7%) region hospitals showed higher rates of recurrent stroke with CUD+ vs. CUD- (p<0.05). Conclusion: The frequency and risk (~50% higher) of recurrent stroke were found to be significantly increased with disparities in subgroups among young adults with prior history of stroke/TIA and concomitant CUD.