Abstract WP235: Cannabis Use Disorder in Elderly Stroke Survivors (≥65 Years) Elevates the Risk of Stroke Recurrence: An Analysis From the National Inpatient Sample (2016-2019)

Abstract

Introduction: Amid the rising prevalence of cannabis use disorder (CUD) in older adults and with surveys reporting ~85% of overlapping use for medicinal and recreational purposes in American cannabis users, the link between CUD and stroke is paramount. This study explores the risk of recurrent acute ischemic stroke (AIS) or hemorrhagic stroke (HS) in CUD while also evaluating the effects of coexisting substance abuse and mental health conditions. Methods: Elderly (age >65 years) stroke survivors were identified using ICD-10 codes from the National Inpatient Sample (2016-2019) and categorized based on the presence or absence of CUD and recurrent AIS or HS. Multivariable statistical methods assessed demographics, comorbidities, and temporal trends. Results: Out of 5,284,119 elderly stroke survivors, 16,820 (0.3%) had CUD and presented younger (median age: 69 vs. 79), predominantly male (68.8% vs. 45.1%), with a larger representation of black individuals (30.8% vs. 12.8%), and higher prevalence in the lowest income quartile (39.7% vs. 28.4%). Comorbidities like diabetes, hyperlipidemia, obesity, and hypothyroidism were less common in CUD patients, but substance abuse and mental health disorders were more prevalent. From 2016 to 2019, CUD among stroke survivors rose from 0.24% to 0.37%. The uptrend was observed across genders, racial groups (except Asians and Native Americans), income quartiles, hospital regions, and in cohorts with and without anxiety, depression, alcohol abuse, and tobacco use. Additionally, the recurrence of AIS decreased from 5.32% to 5.13% in the non-CUD group. After adjustment, the odds of recurrent AIS in the CUD cohort was 1.56 (95% CI:1.35-1.79), and for any stroke type (AIS or HS) 1.44 (95% CI:1.26-1.65). Conclusion: Elderly stroke survivors with concurrent CUD have a 56% increased risk of recurrent AIS and a 44% heightened risk for AIS or HS. The growing prevalence of CUD in this demographic underscores it's escalating clinical significance.