Impact Of Cannabis Use Disorders Research Articles

S109 Impact of Cannabis Use Disorder on In-Hospital Outcomes of Pancreatitis: A Nationwide Inpatient Study Stratified by Etiology

S109 Impact of Cannabis Use Disorder on In-Hospital Outcomes of Pancreatitis: A Nationwide Inpatient Study Stratified by Etiology

The impact of cannabis use disorder on urologic oncologic surgery morbidity, length of stay, and inpatient cost: analysis of the National Inpatient Sample from 2003 to 2014.

This study examined the impact of cannabis use disorder (CUD) on inpatient morbidity, length of stay (LOS), and inpatient cost (IC) of patients undergoing urologic oncologic surgery. The National Inpatient Sample (NIS) from 2003 to 2014 was analyzed for patients undergoing prostatectomy, nephrectomy, or cystectomy (n = 1,612,743). CUD was identified using ICD-9 codes. Complex-survey procedures were used to compare patients with and without CUD. Inpatient major complications, high LOS (4th quartile), and high IC (4th quartile) were examined as endpoints. Univariable and multivariable analysis (MVA) were performed to compare groups. The incidence of CUD increased from 51 per 100,000 admissions in 2003 to 383 per 100,000 in 2014 (p < 0.001). Overall, 3,503 admissions had CUD. Patients with CUD were more frequently younger (50 vs. 61), male (86% vs. 78.4%), Black (21.7% vs. 9.2%), and had 1st quartile income (36.1% vs. 20.6%); all p < 0.001. CUD had no impact on any complication rates (all p > 0.05). However, CUD patients had higher LOS (3 vs. 2days; p < 0.001) and IC ($15,609 vs. $12,415; p < 0.001). On MVA, CUD was not an independent predictor of major complications (p = 0.6). Conversely, CUD was associated with high LOS (odds ratio (OR) 1.31; 95% CI 1.08-1.59) and high IC (OR 1.33; 95% CI 1.12-1.59), both p < 0.01. The incidence of CUD at the time of urologic oncologic surgery is increasing. Future research should look into the cause of our observed phenomena and how to decrease LOS and IC in CUD patients.

Abstract TP228: Association of Dependent Cannabis Use in Patients With Chronic Liver Disease With Stroke Hospitalizations and Subsequent Mortality: A Nationwide Analysis

Introduction: Chronic liver disease (CLD) predisposes to systemic manifestations like thrombocytopenia and coagulopathy that can trigger stroke onset. Cannabis, due to its anti-inflammatory effects, could have a potential benefit for CLD patients. We aimed to study the impact of cannabis use disorder (CUD) or dependent use on stroke risk in CLD, considering recent American and Canadian surveys reporting 85% overlap between medicinal and recreational use. Methods: The National Inpatient Sample, 2019, was queried to identify adult stroke hospitalizations in patients with CLD. Two cohorts were created based on the presence of CUD. The primary outcomes were the rates and odds of stroke or acute ischemic stroke (AIS), with subsequent mortality in CUD vs. non-CUD cohorts. Secondary outcomes were resource utilization. Multivariable regression was controlled for patient-hospital-level factors and relevant comorbidities. Results: The CUD+ cohort had a lower rate of both overall stroke hospitalization (1.2% vs. 2.0%) and AIS hospitalization (0.8% vs. 1.2%) as compared to the CUD- cohort (p&lt;0.001). The median age of admissions for stroke and CLD with CUD was 58 years, whereas it was 64 years in the non-CUD cohort. Traditional CVD risk burden was lower, but uncomplicated hypertension, PVD, prior MI, and drug abuse were more prevalent in the CUD+ cohort. Patients with CLD and CUD showed lower odds of any stroke (OR: 0.61, 95% CI: 0.51-0.73; p &lt;0.001) and AIS (OR: 0.68, 95% CI: 0.55-0.85; p = 0.001) vs. the CUD- cohort. When adjusted for confounders, the odds of overall stroke risk were still lower (OR: 0.81; 95% CI: 0.66-0.98; p = 0.029) among the CUD+ cohort. However, adjusted odds for AIS showed no statistical significance (OR: 0.94; 95% CI: 0.74-1.19; p = 0.594). The all-cause mortality in the CUD+ cohort was lower compared to the CUD- cohort: 11.0% vs. 14.4%, p= 0.017, with shorter hospital stays and frequent routine discharges. Conclusion: This nationwide study revealed significantly reduced odds [20%] of stroke hospitalization in adults with CLD using cannabis on a regular, habitual basis. However, more prospective controlled studies are required to evaluate its impact on cardio-cerebrovascular risk with clarity on dose, duration, and mode of CUD in the long term.

Cannabis use disorder contributes to cognitive dysfunction in Veterans with traumatic brain injury.

While emerging evidence supports a link between traumatic brain injury (TBI) and progressive cognitive dysfunction in Veterans, there is insufficient information on the impact of cannabis use disorder (CUD) on long-term cognitive disorders. This study aimed to examine the incidences of cognitive disorders in Veterans with TBI and CUD and to evaluate their relationship. This retrospective cohort study used the US Department of Veterans Affairs and Department of Defense administrative data from the Long-term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium Phenotype study. Diagnoses suggesting cognitive disorders after a TBI index date were identified using inpatient and outpatient data from 2003 to 2022. We compared the differential cognitive disorders incidence in Veterans who had the following: (1) no CUD or TBI (control group), (2) CUD only, (3) TBI only, and (4) comorbid CUD+TBI. Kaplan-Meier analyses were used to estimate the overall cognitive disorders incidence in the above study groups. The crude and adjusted Cox proportional hazards models were used to estimate crude and adjusted hazard ratios (HRs) for cognitive disorders. A total of 1,560,556 Veterans [82.32% male, median (IQR) age at the time of TBI, 34.51 (11.29) years, and 61.35% white] were evaluated. The cognitive disorder incidence rates were estimated as 0.68 (95% CI, 0.62, 0.75) for CUD only and 1.03 (95% CI, 1.00, 1.06) for TBI only per 10,000 person-months of observations, with the highest estimated cognitive disorder incidence observed in participants with both TBI and CUD [1.83 (95% CI, 1.72, 1.95)]. Relative to the control group, the highest hazard of cognitive disorders was observed in Veterans with CUD+TBI [hazard ratio (HR), 3.26; 95% CI, 2.91, 3.65], followed by those with TBI only (2.32; 95 CI%, 2.13, 2.53) and with CUD (1.79; 95 CI%, 1.60, 2.00). Of note, in the CUD only subgroup, we also observed the highest risk of an early onset cognitive disorder other than Alzheimer's disease and Frontotemporal dementia. The results of this analysis suggest that individuals with comorbid TBI and CUD may be at increased risk for early onset cognitive disorders, including dementia.

The economic impact of cannabis use disorder and dementia diagnosis in veterans diagnosed with traumatic brain injury.

Studies have demonstrated that individuals diagnosed with traumatic brain injury (TBI) frequently use medical and recreational cannabis to treat persistent symptoms of TBI, such as chronic pain and sleep disturbances, which can lead to cannabis use disorder (CUD). We aimed to determine the Veterans Health Administration (VHA) healthcare utilization and costs associated with CUD and dementia diagnosis in veterans with TBI. This observational study used administrative datasets from the population of post-9/11 veterans from the Long-term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium and the VA Data Warehouse. We compared the differential VHA costs among the following cohorts of veterans: (1) No dementia diagnosis and No CUD group, (2) Dementia diagnosis only (Dementia only), (3) CUD only, and (4) comorbid dementia diagnosis and CUD (Dementia and CUD). Generalized estimating equations and negative binomial regression models were used to estimate total annual costs (inflation-adjusted) and the incidence rate of healthcare utilization, respectively, by dementia diagnosis and CUD status. Data from 387,770 veterans with TBI (88.4% men; median [interquartile range (IQR)] age at the time of TBI: 30 [14] years; 63.5% white) were followed from 2000 to 2020. Overall, we observed a trend of gradually increasing healthcare costs 5 years after TBI onset. Interestingly, in this cohort of veterans within 5 years of TBI, we observed substantial healthcare costs in the Dementia only group (peak = $46,808) that were not observed in the CUD and dementia group. Relative to those without either condition, the annual total VHA costs were $3,368 higher in the CUD only group, while no significant differences were observed in the Dementia only and Dementia and CUD groups. The findings suggest that those in the Dementia only group might be getting their healthcare needs met more quickly and within 5 years of TBI diagnosis, whereas veterans in the Dementia and CUD group are not receiving early care, resulting in higher long-term healthcare costs. Further investigations should examine what impact the timing of dementia and CUD diagnoses have on specific categories of inpatient and outpatient care in VA and community care facilities.

Unraveling the Link: Cannabis Use Disorder and Pulmonary Embolism-Related Hospital Outcomes in Female Breast Cancer Survivors

Background: The use of cannabis in cancer patients has gained significant attention due to its analgesic properties, which help alleviate cancer-related pain. Studies have also shown the interference of cannabis with the coagulation system. We aimed to study the impact of cannabis use disorder (CUD) and Pulmonary embolism (PE) on outcomes in female breast cancer survivors, considering reports suggesting significant overlap between recreational and medicinal use. Our objective was to compare outcomes in CUD+ (with cannabis use disorder) and CUD- (without cannabis use disorder) cohorts to gain critical insights into this group and understand the impact of CUD on PE-related hospitalization and outcomes. Methods: National Inpatient Sample (NIS) data from 2020 was utilized in order to analyze inpatient cohorts of PE hospitalizations. The International Classification of Diseases 10 (ICD 10) codes for pulmonary embolism, cannabis use disorder, and female breast cancer were utilized to classify cohorts. All cases of female breast cancer and pulmonary embolism with an age &amp;gt;18 years were included in the final analysis. The primary outcome was the impact of CUD on PE-related hospitalizations in female breast cancer survivors. We also compared demographic correlations and comorbidities affecting outcomes between cohorts. Results: This study included a total of 508065 admissions among breast cancer survivors, with a median age of 74 years for the entire cohort. The prevalence of PE admissions was lower in CUD+ cohort compared to CUD- cohort (1.3% vs. 2.1%). The CUD+ cohort was relatively younger (median 66 vs 74 years, p&amp;lt;0.001). Overall, admission rates were higher among white patients (77%) and this trend was statistically significantly higher in the 76-100 th percentile household income group (p&amp;lt;0.002) compared to CUD+(50%) and CUD-(26.5%). Most admissions were non-elective (95.4%), with no statistical significance between CUD- and CUD+ patients (p=0.16). The majority of readmissions occurred in urban teaching hospitals (75.5%), with no significant difference observed between CUD- and CUD+ patients (p=0.111). Regionally, the South had a higher admission rate (37.2%) compared to other regions and this difference was statistically significant (p&amp;lt;0.001) between CUD- and CUD+ patients. Among the coexisting comorbidities, hypertension showed a significant difference between CUD- (70%) and CUD+(37.5%) patients (p&amp;lt;0.001). Alcohol use disorder (p&amp;lt;0.001) and cancer (p&amp;lt;0.001) had significant associations with CUD+, along with prior myocardial infarction (p=0.005) and drug use (p&amp;lt;0.001) were significantly associated with CUD+.Furthermore, there was difference in routine patient disposition between between CUD-(45.3%) and CUD+(37.5%),(p=0.033) and length of stay (4 VS 2 days), (p=0.033) and cost of stay (47033 vs 27668 $), (p=0.017). The multivariable logistic regression analysis showed that the odds of PE-related hospitalization in CUD+ vs CUD- cohorts among female breast cancer survivors were not statistically significant, with an OR of 0.79 (CI: 0.38-1.62, p=0.512). Subgroup analysis by age demonstrated no statistically significant differences in odds for PE-related hospitalization between CUD+ and CUD- cohorts. For the age group of 18-44 years, the OR was 1.37 (CI: 0.18-10.60, p=0.762). In the 45-64 years age group, the OR was 0.48 (CI: 0.15-1.53, p=0.215), and for those aged ≥65 years, the OR was 1.32 (CI: 0.48-3.67, p=0.590). Furthermore, the analysis by race indicated that the odds of PE-related hospitalization did not reach statistical significance in both white and black female breast cancer survivors with CUD. For white patients, the OR was 0.64 (CI: 0.23-1.73, p=0.375), while for black patients, the OR was 1.15 (CI: 0.38-3.46, p=0.804). Conclusion: Among female breast cancer survivors, the presence of CUD did not show a statistically significant impact on the odds of PE-related hospitalization. Subgroup analysis by age and race also revealed no significant differences in the odds of PE-related hospitalization between CUD+ and CUD- cohorts. These findings underscore the importance of considering CUD when managing pulmonary embolism in breast cancer survivor females and emphasize the need for further research to understand the complex interplay between these factors.

Abstract 15309: Prevalence of Dependent Cannabis Use in Patients Hospitalized With Peripheral Vascular Disease and Concomitant Tobacco Use Disorder and Associated Major Adverse Cardiac Events: National Inpatient Sample Analysis 2019

Introduction: Cannabis use disorder (CUD) and tobacco use disorder (TUD) are independent risk factors for patients hospitalized with peripheral vascular disease (PVD) and major adverse cardiac and cerebrovascular events (MACCE). However, the impact of CUD on PVD with concomitant TUD and associated MACCE remains unexplored, despite the increasing prevalence of cannabis use in the USA. Methods: Using the 2019 National Inpatient Sample and relevant ICD-10-CM codes, we identified hospitalizations in patients with PVD and TUD. Baseline demographics, comorbidities, and major adverse cardiac events were compared between CUD+ vs CUD- cohorts. A multivariable regression analysis was conducted, adjusting for confounders to assess the odds of MACCE. Results: Among 363,795 patients admitted with PVD and TUD, 13,440 (3.7%) had CUD+ [median age 57 (48-64)], with a higher proportion of males (70.5% vs 60.8%) and black patients (27.8% vs 14.7%) compared to the CUD-cohort (all p&lt;0.001). The CUD+ cohort exhibited higher rates of alcohol abuse (21.4% vs 11.1%), drug abuse (47% vs 6%), depression (19.2% vs 16.2%), and prior VTE (11% vs 9.2%) (all p&lt;0.001). Overall, MACCE was reported to be high in the CUD+ cohort (18.1% vs. 16.4%). After adjusting for covariates, the CUD+ cohort had significantly higher odds of developing MACCE in the middle-aged (45-64 years) (OR:1.20, 95%CI: 1.04-1.38, p=0.014) and the male subpopulation (OR:1.20, 95%CI: 1.01-1.42, p=0.039). Subgroup analysis revealed that complicated hypertension (OR:1.80, 95%CI:1.28-2.53), hyperlipidemia (OR:1.59, 95%CI: 1.20-2.13), and prior TIA (OR:1.48, 95% CI:1.02-2.16) were significant predictors for the MACCE middle-aged cohort (all p&lt; 0.05) (Table 1). Conclusion: In CUD+TUD cohorts with PAD, men and middle-aged individuals had greater odds of MACCE. Therefore, clinicians should be aware of this high-risk population, and further prospective studies are required for a significant association.

1.62 Impact of Cannabis Use Disorder on Risk of Inpatient Psychiatric Hospitalization Related to Suicidal Thoughts and Behaviors Among US Adolescent and Young Adults With Mood Disorders

1.62 Impact of Cannabis Use Disorder on Risk of Inpatient Psychiatric Hospitalization Related to Suicidal Thoughts and Behaviors Among US Adolescent and Young Adults With Mood Disorders

S815 Impact of Cannabis Use Disorder on In-Hospital Mortality in Geriatric Population Hospitalized With Gastrointestinal Hemorrhage: A National Population Based Analysis

S815 Impact of Cannabis Use Disorder on In-Hospital Mortality in Geriatric Population Hospitalized With Gastrointestinal Hemorrhage: A National Population Based Analysis

Cannabis use disorder uniquely predicts educational impairment in college students over and above other mental health disorders

Objective: The impact of cannabis use disorder (CUD) on education functioning and GPA was examined within the context of co-occurring alcohol use disorder (AUD), major depressive disorder (MDD), and post-traumatic stress disorder (PTSD). Participants: Undergraduates (N = 210) who reported using cannabis within the past six months were recruited. Methods: Hierarchical multiple regression analyses were used to determine whether CUD symptom severity and presence of probable CUD diagnosis predicted educational impairment and current GPA, over and above other mental health conditions. Results: CUD symptom severity, but not probable CUD, significantly predicted greater educational impairment, over and above probable PTSD and MDD, which were also significant predictors. CUD symptom severity, but not probable CUD, significantly predicted lower GPA. Conclusion: In addition to other common mental health conditions, CUD may be an important area of assessment and intervention for university counseling centers to foster student academic success.

Abstract 13841: Prevalence and Impact of Recreational Cannabis Use on Acute Ischemic Stroke and Related Mortality in Elderly (≥65 Yrs) Peripheral Vascular Disease Patients: A Population-Based Analysis in the US (2016-2019)

Background: Considering preliminary reports suggesting associations between peripheral atherosclerotic disease (cannabis arteritis) and acute ischemic stroke (AIS) with cannabis use disorder (CUD), we sought to study the burden and impact of CUD on AIS risk and outcomes in the elderly with PVD. Methods: The National Inpatient Sample (2016-2019) was used to identify geriatric PVD admissions with vs. without CUD . We compared the burden and risk of AIS admissions with vs. without CUD and subsequent in-hospital mortality using adjusted multivariable regression analyses. Results: Of 5,115,824 total geriatric admissions with PVD (50.6% males, 77.5% white), 21,405 had CUD. The prevalence of DM was lower in the CUD cohort (19.7% vs 33.7%) with comparable rates of HTN and smoking between groups [Table 1]. Concomitant drug use was higher in CUD vs non-CUD cohort. There was AIS period prevalence of 5.2% in CUD vs 4.0% in non-CUD cohorts (p&lt;0.001). Among geriatric PVD patients, CUD was associated with higher odds of AIS hospitalizations aOR 1.34 (95%CI 1.18-1.52, p&lt;0.001) without a statistically significant difference in subsequent all-cause in-hospital mortality (aOR 0.71, 95%CI 0.36-1.37, p=0.302). Elderly PVD patients with HTN (aOR 1 .73) predicted higher risk of AIS, however, interestingly, concomitant tobacco use disorder revealed a paradox protective effect while assessing the predictors of AIS in elderly PVD patients with CUD (aOR 0.58 95CI 0.42-0.79, p&lt;0.001). Conclusions: There is a 34% risk of AIS in Geriatric PVD patients with CUD even after controlling for CVD risk factors and drug abuse. Future studies are warranted to explore and confirm the observed smoker’s paradox.

S992 Burden and Impact of Cannabis Use Disorder on IBD Flare-Up/Emergent Admissions: A National Population-Based Analysis

S992 Burden and Impact of Cannabis Use Disorder on IBD Flare-Up/Emergent Admissions: A National Population-Based Analysis

Abstract 13028: Cannabis Use Disorder Adversely Affects Outcomes of Diabetics Hospitalized With Prior Myocardial Infarction and Revascularization: A National Propensity-Matched Analysis

Background: Increasing unmonitored use of recreational cannabis in the United States is alarming especially among patients with known cardiovascular disease (CVD) risk. Considering mixed reports of cannabis use and its impact on diabetes mellitus and associated outcomes, we aimed to assess the impact of cannabis use disorder (CUD) on outcomes of diabetics hospitalized with prior myocardial infarction (MI) and revascularization [PCI and/or CABG]. Methods: We queried the National Inpatient Sample (2015Oct-2017Dec) to identify admissions among diabetics with prior revascularized MI and CUD. Propensity score-matched analysis (1:1) was performed adjusting for demographic and hospital characteristics to obtain CUD+ &amp; CUD- cohorts which were then compared for comorbidities and in-hospital outcomes. Primary outcomes were major adverse cardiac and cerebrovascular events (MACCE: all-cause mortality, acute MI, cardiac arrest and stroke) and subsequent revascularization and secondary outcomes were median hospital stay and charges. Results: Each diabetic cohort with prior MI and revascularization consisted of 190 patients with and without CUD (CUD+ vs. CUD-). Both matched cohorts were comparable in terms of demographics (Table 1) and had balanced distribution of most of the CVD risk factors except hypertension (92.1% vs. 97.4%; p=0.022) and renal failure (18.4% vs. 28.9%; p=0.016) which were lower in the CUD+ cohort. The rates of MACCE (28.9% vs. 10.5%) and revascularization (23.7% vs. 7.9%, p&lt;0.001) were significantly higher in the CUD+ cohort (p&lt;0.001). Furthermore, the CUD+ cohort was less often routinely discharged (63.2% vs. 76.3%) with higher length of stay (4 vs. 3 days) and hospital charges. Conclusion: This nationwide propensity-matched analysis revealed that the CUD increases the rates of MACCE, subsequent revascularization with higher healthcare resource utilization in diabetics hospitalized with a prior history of MI and revascularization.

Abstract 9882: Cannabis Use Poses Alarming Risk of Atrial Tachyarrhythmia and Stroke in Young Patients with Obesity Associated Obstructive Sleep Apnea: A Propensity-Score Matched Analysis

Introduction: Obesity is a known risk factor and causes worse cardiovascular outcomes in obstructive sleep apnea. With the growing use of cannabis in the US, so we aimed to assess the impact of cannabis use disorder (CUD) on risk of atrial tachyarrhythmias (atrial fibrillation, AF; atrial fibrillation, AFL) and stroke in young patients with obesity-associated obstructive sleep apnea (OOSA). Methods: The National Inpatient Sample (2015Oct-2017) with relevant ICD-10 codes were used to identify admissions among young adults (18-44 years) with OOSA. We then matched (1:1) two cohorts of cannabis use disorder (CUD+) vs. without (CUD-) with controlling potential sociodemographic confounders. Primary outcomes of interest were frequency and risk of atrial tachyarrhythmias and stroke assessed by multivariable analysis. Results: Of 7470 demographically-matched OOSA admissions, CUD+ and CUD- cohorts had 3735 hospitalizations in each cohort. Both cohorts were comparable mean age of 38 years and CUD+ cohort more frequently included male (66.6% vs. 53.5%), African American (40.0% vs. 30.1%) patients admitted non-electively (92.3% vs. 84.5%). Rates of drug abuse, hypertension, smoking and chronic pulmonary disease were higher but diabetes mellitus, hyperlipidemia, and renal failure were lower in CUD+ cohort vs. CUD- cohort (p&lt;0.001). The frequency of AF/AFL (5.7% vs 7.4%) related admissions were lower; however, the risk of AF/AFL (OR:1.64, 95%CI:1.17-2.30, p=0.004) and stroke (OR:4.41, 95%CI:1.41-13.77, p&lt;0.011) admissions were significantly higher in the OOSA-CUD+ cohort vs. CUD- cohort in the multivariable analysis controlled for relevant cardiovascular/extracardiac comorbidities and concomitant alcohol/drug abuse and smoking. Conclusions: This propensity-matched analysis highlights that recreational cannabis use in young patients with OOSA may alarmingly increase emergency hospitalizations and independently increase the risk of AF/AFL and stroke.

Abstract 13645: Contemporary Propensity-Matched Analysis Reveals Alarmingly High Risk Of Mortality, Arrhythmia And Cardiac Arrest In Nationwide Hospitalizations Of Patients With Heart Failure With Preserved Ejection Fraction And Cannabis Use Disorder

Background: Preliminary reports have suggested a link between cannabis use and heart failure (HF); however, with inconclusive literature on the subject, there exists an unmet need for contemporary data on outcomes of HF patients with cannabis use. The rising prevalence of Heart Failure with Preserved Ejection Fraction (HFpEF) incited us to assess the impact of cannabis use disorder (CUD) on in-hospital outcomes of HFpEF using nationwide multicenter data. Methods: Adult admissions related to HFpEF with vs. without CUD were identified using the National Inpatient Sample (Oct 2015-Dec 2017). Demographically matched cohorts, HFpEF-CUD+ vs. HFpEF-CUD-, were obtained and compared for comorbidities and in-hospital outcomes. Multivariable regression analyses were performed after controlling for confounders (demographic/hospital characteristics, comorbidities and substance abuse) to assess the risk of adverse outcomes including all-cause mortality, arrhythmia (atrial fibrillation/flutter, ventricular arrhythmia &amp; cardiac arrest) and stroke. Results: Of 3,835,473 HFpEF-related admissions, 10980 (0.3%) patients were cannabis users. Matched cohorts, CUD+ and CUD- were comparable for demographics (median age 55 vs. 54 years, &gt;60% male, &gt;80% white/black). The CUD+ cohort had a lower rate of comorbidities including hypertension (87.5% vs 88.5%), diabetes (33.7% vs 43.7%), hyperlipidemia (38.4% vs 42.1%), obesity (26.7% vs 36.2%), and renal failure (32.8% vs 39.8%) (Table 1). Despite a lower comorbidity burden, the CUD+ cohort was often admitted non-electively (95.2% vs. 92.8%) and had considerably higher odds of all-cause mortality (aOR 2.24, 95%CI:1.81-2.78), arrhythmia (aOR 1.15, 95%CI:1.05-1.25) and cardiac arrest (aOR 3.87, 95%CI: 2.88-5.21) (p&lt;0.05) (Fig. 1). Conclusions: This nationwide multicenter analysis revealed HFpEF admissions in patients with CUD had a significantly higher risk of adverse in-hospital outcomes despite a lower CVD risk.

Abstract 15863: Prevalence, Trends and Impact of Cannabis Use on Hospitalizations With Prior Myocardial Infarction and Revascularization

Background: With the rise of cannabis use in the USA, we aim to assess its prevalence and impact on admissions with prior myocardial infarction and revascularization [percutaneous coronary intervention (PCI) and/or coronary artery bypass grafting (CABG)]. Methods: We queried the National Inpatient Sample (2007-2014) to identify admissions with prior MI/PCI/CABG for the prevalence, trends and impact of cannabis use disorder. Results: Patients cohort with prior MI and revascularization with cannabis use consisted of younger (median age years 53 (46-59) vs 72 (63-81), African American (34.3% vs. 10.0%) male (76.5% vs. 61.5%) patients v/s non cannabis users (p&lt;0.001). Co-morbid conditions such as hypertension (71.7% vs. 74.8%), diabetes, uncomplicated (23.6% vs. 32.9%), dyslipidemia (51.3% vs. 57.8%) (p&lt; 0.001) were significantly lower in cannabis users. There were increasing trends of cannabis use from 0.2 to 0.7% over the study period with a higher rate of AMI (7.2% vs 4.5%), PCI (6.2% vs 5.5%) and CABG (1.9% vs 1.5%) in cannabis users as shown in Fig 1a and 1b . All-cause mortality (0.8% vs 2.5%), hospital charges (21556 vs 24872) were low among cannabis users. Subsequent AMI in cannabis users was 67% v/s 41% in non-cannabis users. Conclusion: There are alarmingly rising trends in cannabis use in patients with prior MI/PCI/CABG from 2017-2014. Even with younger and overall lower comorbidity burden in cannabis users, the frequency of recurrent AMI and revascularization was seen higher but lower inpatient mortality.

Is Cannabis Use Associated With the Worst Inpatient Outcomes in Attention Deficit Hyperactivity Disorder Adolescents?

ObjectiveTo determine the impact of cannabis use disorder (CUD) on the inpatient outcomes of attention deficit hyperactivity disorder (ADHD) in adolescentsBackgroundPrevious studies have evaluated the impact of CUD on the health-related quality of life in ADHD patients.MethodsWe used the nationwide inpatient sample (NIS) from the Healthcare Cost and Utilization Project (HCUP) from years 2010­–2014. We identified ADHD and cannabis use (CU) as the primary and the other diagnosis, respectively, using validated International Classification of Diseases, 9th Revision, and Clinical Modification (ICD­9–­CM) codes. We used the binomial logistic regression model to generate adjusted odds ratios (aOR).ResultsWe analyzed a total of 11,232 ADHD adolescent hospital admissions from years 2010–2014; of these, 1.79% had CUD. The mean age of adolescents was 14.1 years (SD = 1.79). The prevalence of CUD was highest in ADHD adolescents of 15-18 years (73%) and common in the white race (71%). A higher proportion of ADHD with CUD was transferred to acute care hospitals and skilled/other nursing facilities (5.4% and 7.4% vs. 1.1% and 2.6%, respectively, p-value < 0.001). CUD increases the risk of inpatient charges > $12,247 (median) by 0.6 times (aOR = 1.835; p-value = 0.002) and increases the risk of inpatient stay > 5 days (median) by 0.7 times (aOR = 2.099; p-value < 0.001). The utilization of psychotropic medications was reduced by 0.8 times in ADHD with CUD adolescents by 0.8 times (aOR = 0.448; p-value = 0.017), and the implication of behavioral therapy in the management of ADHD with CUD adolescents was reduced by 0.9 times (aOR = 0.412; p-value = 0.048). Also, there is a 2.8 times higher risk of comorbid alcohol abuse in ADHD with CUD adolescents (aOR = 17.141; p-value < 0.001).ConclusionThe increased risk of substance use is a long-term implication of ADHD in adolescents. It has been determined that comorbid CUD in patients with ADHD not only increases the risk of acute inpatient care but also prolongs the inpatient stay, thus increasing the healthcare cost. Surprisingly, comorbid CUD decreases the utilization of psychotropic medications and behavioral therapy in ADHD. Another major issue is the higher risk of comorbid alcohol abuse in ADHD with CUD adolescents. Further exploration with randomized controlled studies would be required to support and highlight the growing issue of cannabis use among adolescents with ADHD.

The Impact of Cannabis Use Disorder on Suicidal and Nonsuicidal Self-Injury in Iraq/Afghanistan-Era Veterans with and without Mental Health Disorders.

The objective of this study was to assess the association between cannabis use disorder (CUD) and self-injury among veterans. As expected, after adjusting for sex, age, sexual orientation, combat exposure, traumatic life events, traumatic brain injury, posttraumatic stress disorder, depression, alcohol use disorder, and noncannabis drug use disorder, CUD was significantly associated with both suicidal (OR=3.10, p=.045) and nonsuicidal (OR=5.12, p=.009) self-injury. CUD was the only variable significantly associated with self-injury in all three models examined. These findings are consistent with prior research among civilians and suggest that CUD may also increase veterans' risk for self-injurious behavior.

Altered cortical maturation in adolescent cannabis users with and without schizophrenia

During late adolescence, progressive cortical thinning occurs in heteromodal association cortex (HASC) that is thought to subserve cognitive development. However, the impact of cannabis use disorder (CUD) upon cortical gray matter development in both healthy adolescents and adolescents with early-onset schizophrenia (EOS) is unclear. T1-weighted magnetic resonance images were acquired from 79 adolescents at baseline and after an 18-month follow-up: 17 with EOS, 17 with CUD, 11 with EOS+CUD, and 34 healthy controls (HC). Mean age at baseline was 16.4years (CUD+) and 17.0years (CUD−). Using FreeSurfer, measures of cortical thickness for ROIs within HASC were obtained. A 2 (EOS versus no EOS)×2 (CUD versus no CUD) multivariate analysis of covariance was applied to change scores from baseline to follow-up to test for main effects of EOS and CUD and an interaction effect. After adjusting for covariates, a significant main effect of CUD was observed. Adolescents with CUD showed an attenuated loss of cortical thickness in the left and right supramarginal, left and right inferior parietal, right pars triangularis, left pars opercularis, left superior frontal, and left superior temporal regions compared to non-using subjects. Stepwise linear regression analysis indicated that greater cumulative cannabis exposure predicted greater cortical thickness in both the left (p=.008) and right (p=.04) superior frontal gyri at study endpoint after adjusting for baseline cortical thickness for the entire sample. These preliminary longitudinal data demonstrate an atypical pattern of cortical development in HASC in adolescents with CUD relative to non-using subjects, across diagnostic groups. Additional studies are needed to replicate these data and to clarify the clinical significance of these findings.

Prospective investigation of the impact of cannabis use disorders on posttraumatic stress disorder symptoms among veterans in residential treatment.

Prospective investigation of the impact of cannabis use disorders on posttraumatic stress disorder symptoms among veterans in residential treatment.