Congestive Heart Failure Hospitalizations and Cannabis Use Disorder (2010-2014): National Trends and Outcomes.

Temitope Ajibawo,Rikinkumar S Patel,Uvie Ajibawo-Aganbi,Farla Jean-Louis

doi:10.7759/cureus.8958

Temitope Ajibawo, Rikinkumar S Patel + Show 2 more

Open Access

https://doi.org/10.7759/cureus.8958

Copy DOI

Abstract

Background and objectives: Prior studies have suggested that cannabis use is an independent risk factor for heart failure. With increasing recreational use of cannabis and decriminalization policies, cannabis use is expected to add to the burden of heart failure, but there is still limited data. Therefore, we utilized the Nationwide Inpatient Sample (NIS) database (2010-2014) to study the national trends and outcomes among cannabis users admitted for congestive heart failure (CHF).Methods: We queried the NIS database and identified CHF as the primary diagnosis with a co-diagnosis of cannabis use disorder (CUD). Trends were analyzed with the linear-by-linear association.Results: Total CHF admissions (N = 4,596,024) with comorbid CUD (N = 23,358 (0.5%)) were identified. An increasing prevalence trend from 0.4% to 0.7% (P= 0.001) was seen. CUD patients had a mean age of 49.78 years, 79% were males, 55.4% were African Americans, and 73.6% earn ≤ 50th percentile median household income of the patient’s ZIP code. Inpatient deaths (1.1% vs. 3.1%) were lower (P<0.001), and mean length of stay (LOS) was shorter among cannabis users compared to non-users (P=0.001). The mean LOS and total hospitalization costs demonstrated an increasing trend (Ptrend = 0.001 and Ptrend < 0.001) respectively. Alcohol abuse and depression were more prevalent among CUD compared to non-CUD patients.Conclusion: CUD was associated with reduced inpatient deaths, but the prevalence of CUD and hospital charges is on the rise in the CHF inpatient population in addition to shorter mean LOS. Notwithstanding, these above findings prompt further research into its underlying mechanisms along with a probable causal relationship between cannabis and heart failure.

Highlights

The past decade has witnessed unprecedented legalization and decriminalization of cannabis use across many states in the United States [1]
The total number of admissions identified with a primary diagnosis of congestive heart failure (CHF) over the five years was N = 4,596,024, and 0.5% (N = 23,358) of these patients had a co-diagnosis of cannabis use disorder (CUD) as shown in Table 1 below
We reported an overall prevalence of CUD among CHF inpatients as 0.5% and a significant trend of 77.4%

Summary

Introduction

The past decade has witnessed unprecedented legalization and decriminalization of cannabis use across many states in the United States [1]. Heart failure constitutes a significant public health issue, and its estimated prevalence is >5.7 million in the United States (US) [4]. The lifetime risk of developing heart failure is estimated to be 20% [4]. The consensus from a few published case reports and studies is that cannabis use may be associated with the development of left ventricular dysfunction and heart failure [5,6,7,8]. Prior studies have suggested that cannabis use is an independent risk factor for heart failure. With increasing recreational use of cannabis and decriminalization policies, cannabis use is expected to add to the burden of heart failure, but there is still limited data. We utilized the Nationwide Inpatient Sample (NIS) database (2010-2014) to study the national trends and outcomes among cannabis users admitted for congestive heart failure (CHF)

Methods

Results

Discussion

Conclusion