Robert Wood Johnson Medical School, Rutgers University New Brunswick, NJ, United States
Award: Presidential Poster Award
Eric Zhao, MD, Savan Kabaria, MD, Anish V. Patel, MD Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ
Introduction: Cannabis use for medical purposes is a widely debated topic. There is limited data on the impact of cannabis in patients with cirrhosis. This study aims to understand the effect on morbidity and mortality of cannabis use among cirrhosis patients.
Methods: The patient cohort was extracted from the Nationwide Inpatient Sample from October 1st, 2015, to December 31st, 2018, using International Classification of Disease 10 (ICD-10) codes for cannabis use, cirrhosis, and various comorbidities and outcomes. We estimated the incidence, various factors of morbidity, and in-hospital mortality, among patients with compensated and decompensated cirrhosis stratified by cannabis use. Multivariate regression model was generated using demographic, hospital-level characteristics, and comorbidities to obtain the adjusted odds ratios (aOR).
Results: A total of 311,701 patients with cirrhosis were identified over the study period. Of these, 187,042 (60%) had compensated cirrhosis, and 124,659 (40%) had decompensated cirrhosis. Among compensated and decompensated cirrhotics, 2,927 patients (1.56%) and 1,731 (1.39%) were cannabis users, respectively. On multivariate analysis, patients with cannabis use had significantly decreased odds of mortality among both compensated (aOR 0.63; 95% Confidence Interval [CI] 0.50-0.80) and decompensated cirrhotics (aOR 0.67; 95% CI 0.54-0.83), compared to patients without cannabis use. Furthermore, decompensated cirrhotics with cannabis use had decreased odds of intensive care unit (ICU) admissions (aOR 0.76; 95% CI 0.64-0.90) and new-onset dialysis (aOR 0.49; 95% CI 0.38-0.65) compared to those without cannabis use. Similarly, compensated cirrhotics with cannabis use had decreased odds of new-onset dialysis (aOR 0.57; 95% CI 0.45-0.70).
Discussion: We conducted a retrospective study which demonstrated that both compensated and decompensated cirrhotic patients with cannabis use had decreased odds of inpatient mortality when compared to those without cannabis use. In addition, these patients were less likely to have ICU admissions and/or new-onset dialysis. These findings support the idea that cannabis use may provide medical benefits in cirrhosis. This notion is intriguing as previous studies have demonstrated the endocannabinoid system to be a potential therapeutic target in cirrhosis, possibly through portal pressure reduction. Additional longitudinal randomized studies should be performed to further analyze this relationship.
Disclosures: Eric Zhao indicated no relevant financial relationships. Savan Kabaria indicated no relevant financial relationships. Anish Patel indicated no relevant financial relationships.
Eric Zhao, MD, Savan Kabaria, MD, Anish V. Patel, MD. P2837 - Cannabis Use Decreases Morbidity and Mortality Among Cirrhosis Patients: A National Cohort Study, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.