S11 Impact of Marijuana in Ulcerative Colitis With Nstemi Hospitalizations: Insights From National Inpatient Sample 2016-2019.

Abstract

Background: Marijuana use is increasingly prevalent in patients with ulcerative colitis (UC). Clinical symptoms such as abdominal pain, reduced appetite, and diarrhea improve in some patients after marijuana use; partly due to its psychotropic, neuromodulatory, and immunomodulatory effects via the endocannabinoid pathway. Marijuana use and underlying UC can lead to adverse cardiovascular outcomes, and we aim to study its impact on NSTEMI hospitalizations. Methods: A retrospective analysis of the 2016-2019 NIS was conducted to identify hospitalization (Age ≥18 & non-elective) with acute NSTEMI and concomitant history of UC using ICD-10 codes. Variables were screened with univariate regression, intermediate, co-linear variables were removed before a multivariable regression analysis model was built and performed to calculate the odds ratio. Discharge-level weight analysis was used to produce a national estimate. Results: Out of 142,420,378 hospitalizations, only 7,010 had acute NSTEMI and underlying UC. Only 0.78% of these hospitalizations also reported marijuana use. The mean age of patients who used marijuana was 57.55 yrs vs 70.58 yrs for those who did not. A total of 560 (7.99%) hospitalizations had fatal outcomes; however, the difference in deaths between those who used marijuana vs those who did not was statistically insignificant (9.09% vs 7.99%, P 0.89). Upon multivariate analysis, marijuana is not a risk factor for mortality in UC + NSTEMI (OR 1.11, P 0.907). Factors associated with increased mortality were shock (OR 5.88, P 0.00), AKI (OR 3.44, P 0.00), mech ventilation > 24h (OR 3.44, P 0.00). Marijuana use is also not associated with increased hospital resource utilization (-22557.46$, P 0.42). Factors associated with increased total charges of hospitalization are urban teaching hospital location (rural -48272.37$ p 0.00, urban non-teaching -23378.35$, P 0.00), mech ventilation >24 hr (+170339.6$, P 0.00), HF (+25197.46$, P 0.00), CABG (+152736.6$, P 0.00), and shock (+50532.01$, P 0.000). Marijuana, however, is associated with a lower mean length of stay (LOS) by 3.4 days (P 0.02). Factors associated with higher mean LOS are elixhauser comorbidity (+0.48d, P 0.00), mech ventilation > 24h (+7.35d, P 0.00), shock (+1.72d, p 0.01), ventricular arrhythmias (+1.90d, P 0.02), ESRD on HD (+5.20d, P 0.04), AKI (+2.11d, P 0.00), CABG (+5.62d, P 0.000), and anemia (+1.09d, P 0.02). Conclusion(s): Marijuana is not associated with increase in mortality or total charges of hospitalization in UC patients admitted for acute NSTEMI. Additionally, it is associated with reduced LOS in these hospitalizations, likely due to the lower mean age resulting in quicker recovery and discharge.