E0390 - Decreased Hospitalization Costs and Charges in Cannabis Users With IBD

Tuesday, October 25, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Mohammad Afsh, BA

California University of Science and Medicine
Rancho Cucamonga, CA

Mohammad Afsh, BA¹, Pedro Palacios Argueta, MD², Alfred Nelson, MD, MSc², Jana G. Hashash, MD, MSc³, Francis A. Farraye, MD, MSc², Paul Kröner, MD, MS³
¹California University of Science and Medicine, Colton, CA; ²Mayo Clinic, Jacksonville, FL; ³Mayo Clinic Florida, Jacksonville, FL

Introduction: The use of cannabis for symptom control in patients with inflammatory bowel disease (IBD) is common. Cannabis contains over 500 substances, several of which have exhibited anti-inflammatory properties in murine models. However, human clinical studies show conflicting data regarding its effects on IBD activity. The aim of this study was to examine and compare the clinical outcomes of cannabis users vs. cannabis non-users in admitted patients with IBD using a national database.

Methods: Retrospective, observational study using the National Inpatient Sample (NIS) 2018. All patients with principal ICD10CM codes for IBD were included. The cohort was stratified into ulcerative colitis (UC) and Crohn’s disease (CD). Primary outcome was determining occurrence and odds of admission for IBD in patients with cannabis consumption compared to patients with no cannabis consumption. Secondary outcomes included inpatient morbidity, mortality, colectomy odds, hospital length of stay (LOS), and total hospital costs and charges. Multivariate regression analyses were used to adjust for confounding variables.

Results: A total of 99,530 patient admissions for IBD were included in the study (39% UC), of who 3,095 (3.11%) had associated use of cannabis. Mean age was 36 years and 35% were female. A greater proportion of African Americans were noted to be cannabis users compared to non-cannabis users (26.44% vs 13.30%, respectively). Cannabis-users with CD were noted to have higher odds of admission (aOR:1.17, p< 0.01), while cannabis users with UC had lower odds of admission for IBD (aOR:0.80, p< 0.01) compared to non-cannabis users. Cannabis users with CD displayed lower odds of acute kidney injury (AKI) and multiorgan failure compared to non-cannabis users. Overall, cannabis users had decreased associated hospitalization costs and charges compared to non-cannabis users (Table 1).

Discussion: Cannabis users with UC displayed lower odds of admission compared to non-cannabis users. Although cannabis users with CD had higher odds of admission for IBD, these patients demonstrated lower odds of AKI and multiorgan failure. This may potentially suggest a lower degree of disease activity compared to non-cannabis users. This was also potentially reflected in the overall lesser hospitalization costs and charges. Future studies are needed to better assess inpatient outcomes of cannabis users with IBD, particularly focusing on disease activity.

	Adjusted Odds Ratio	95% Confidence Interval	p-value
IBD Admission Crohn's Disease Ulcerative Colitis	1.03 1.17 0.80	0.97 - 1.14 1.05 - 1.30 0.68 - 0.94	0.48 < 0.01 < 0.01
Mortality Crohn's Disease Ulcerative Colitis	n/a	n/a	n/a
Shock Crohn's Disease Ulcerative Colitis	0.97 0.77 1.30	0.35-2.70 0.18-3.33 0.31-5.49	0.95 0.73 0.72
AKI Crohn's Disease Ulcerative Colitis	0.81 0.52 1.52	0.56-1.18 0.31-0.87 0.88-2.61	0.28 0.01 0.13
SIRS Crohn's Disease Ulcerative Colitis	1.34 1.45 1.32	0.77-2.32 0.72-2.95 0.53-3.26	0.30 0.29 0.55
Multiorgan Failure Crohn's Disease Ulcerative Colitis	0.76 0.48 1.42	0.53-1.11 0.29-0.82 0.83-2.45	0.16 < 0.01 0.20
Colectomy Crohn's Disease Ulcerative Colitis	0.67 0.75 0.56	0.45-1.00 0.46-1.23 0.27-1.17	0.06 0.27 0.13
	No Cannabis Use	Cannabis Use	p-value
Mean Costs (USD$) Crohn's Disease Ulcerative Colitis	$12,152 $11,723 $12,817	$11,033 $11,052 $10,984	< 0.01 < 0.01 0.01
Mean Charges (USD$) Crohn's Disease Ulcerative Colitis	$49,610 $47,612 $52,710	$46,105 $46,549 $44,953	< 0.01 0.10 < 0.01
Mean LOS (days) Crohn's Disease Ulcerative Colitis	5.04 4.89 5.26	4.94 4.87 5.12	0.35 0.55 0.68

Table: Table 1 – Adjusted Odds Ratios and Means for Cannabis Users with IBD Compared to Patients with Non-cannabis Users with IBD.

IBD - Inflammatory Bowel Disease, AKI - Acute Kidney Injury, SIRS - Systemic Inflammatory Response Syndrome, LOS - Length of Stay.

Disclosures:

Mohammad Afsh indicated no relevant financial relationships.

Pedro Palacios Argueta indicated no relevant financial relationships.

Alfred Nelson indicated no relevant financial relationships.

Jana Hashash indicated no relevant financial relationships.

Francis Farraye: Adiso Therapeutics – DSMB. BMS – Advisory Committee/Board Member. Braintree Labs – Advisory Committee/Board Member. GSK – Advisory Committee/Board Member. IBD Educational Group – Advisory Committee/Board Member. Innovation Pharmaceuticals – Stock Options. Iterative Scopes – Advisory Committee/Board Member. Janssen – Advisory Committee/Board Member. Lilly – DSMB. Pfizer – Advisory Committee/Board Member. Sebela – Advisory Committee/Board Member. Theravance – DSMB.

Paul Kröner indicated no relevant financial relationships.

Mohammad Afsh, BA¹, Pedro Palacios Argueta, MD², Alfred Nelson, MD, MSc², Jana G. Hashash, MD, MSc³, Francis A. Farraye, MD, MSc², Paul Kröner, MD, MS³. E0390 - Decreased Hospitalization Costs and Charges in Cannabis Users With IBD, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.