E0350 - Factors Associated With Cannabis Use Among Inpatients With Inflammatory Bowel Disease Exacerbation

Tuesday, October 25, 2022

3:00 PM – 5:00 PM ET

Location: Crown Ballroom

Has Audio

Presenting Author(s)

Ellen Oseni, MD

Long Island Jewish Medical Center, Northshore University Hospital
Manhasset, New York

Ellen Oseni, MD¹, Miriam Blumenthal, ¹, Michael Qiu, ¹, Stephanie Izard, ¹, Anjali Mone, MD², Arun Swaminath, MD³, Keith Sultan, MD⁴
¹Long Island Jewish Medical Center, Northshore University Hospital, Manhasset, NY; ²Lenox Hill Hospital, Manhattan, NY; ³Northwell Health, Lenox Hill Hospital, Manhattan, NY; ⁴Long Island Jewish Medical Center, North Shore University Hospital, Long Island, NY

Introduction: Opioid use for inflammatory bowel disease (IBD) has been associated with an increased risk of disease complications. Many view cannabis as a safer palliative alternative to opioids for IBD. Cannabis use is common in the IBD population and increasingly legally available both for medical and recreational use. Cannabis does not improve inflammation but may mask IBD symptoms, with an unclear impact on disease outcomes. We sought to investigate cofactors associated with cannabis use as a first step before analysis of its impact on patient clinical outcomes.

Methods: We conducted a retrospective review of all adult patients admitted for an IBD exacerbation from 01/01/2016 to 03/01/ 2020 within the Northwell Health Care system. Patients were identified by either a primary or secondary ICD10 code (K50.xx, K51.xx, K52.3), limited to those with an IBD exacerbation defined by administration of IV solumedrol and/or biologic therapy. Pregnant patients and those with IBD related surgeries were excluded. A natural language search of admission documents was performed for the terms “marijuana”, “cannabis”, “pot” and “CBD”. Manual chart review was then performed to confirm cannabis use. IBD disease type, age, gender, race, anxiety, depression, alcohol and tobacco use, Charlson comorbidity index (CCI), inpatient opioid use and length of stay were defined. An adjusted analysis was performed of co-factors to determine any association with cannabis use.

Results: A total of 1021 patient admissions met inclusion criteria; 47.40% with Crohn’s disease and 53.09% female, and 66.01% white. Pre-admission cannabis use was reported by 7.25% of patients and was mostly (63%) for recreational use. On multivariable analysis, younger age was associated with cannabis use, as was male gender, African American race, tobacco and alcohol use, and a diagnosis of anxiety and/or depression, table 1. CCI was associated with cannabis use on univariable, but not on multivariable analysis.

Discussion: Among inpatients with IBD exacerbation, factors associated with cannabis use included age, gender, African American race, tobacco and alcohol use, along with anxiety and depression. Our findings suggest that among IBD patients, cannabis use may be less associated with disease activity than with other patient characteristics. Further analysis of the impact of Cannabis use on IBD outcomes is needed.


	Cannabis use
	Cannabis use (n=74), n (%)	No cannabis use (n=947), n (%)	Univariable OR (95% CI)	p-value	Multivariable OR (95% CI)	p-value
Patient characteristics
Age (years)
Mean (SD)	36.46 (15.52)	45.97 (20.41)	0.98 (0.96, 0.99)	0.0001	0.96 (0.94, 0.99)	0.0009
Gender
Female	22 (29.73)	520 (54.91)	0.35 (0.21, 0.58)	< 0.0001	0.28 (0.16, 0.50)	< 0.0001
Male	52 (70.27)	427 (45.09)	(REF)		(REF)
Race
African American/ Black	21 (28.38)	129 (13.62)	2.51 (1.44, 4.40)	0.0012	2.83 (1.52, 5.27)	0.0011
Asian	3 (4.05)	51 (5.39)	0.91 (0.27, 3.04)	0.8757	1.12 (0.32, 3.97)	0.8622
Other/ Multiracial	9 (12.16)	134 (14.15)	1.04 (0.49, 2.19)	0.9240	1.11 (0.50, 2.47)	0.8016
White	41 (55.41)	633 (66.84)	(REF)		(REF)
Tobacco use
Current	17 (22.97)	83 (8.76)	3.31 (1.78, 6.15)	0.0002	2.95 (1.46, 5.96)	0.0025
Former	12 (16.22)	160 (16.90)	1.21 (0.62, 2.38)	0.5800	1.72 (0.79, 3.74)	0.1721
Never	36 (48.65)	581 (61.35)	(REF)		(REF)
Unknown	9 (12.16)	123 (12.99)	1.18 (0.56, 2.52)	0.6664	1.27 (0.50, 3.21)	0.6114
Alcohol use
Current	17 (22.97)	162 (17.11)	1.32 (0.71, 2.47)	0.3794	1.03 (0.52, 2.05)	0.9246
Former	6 (8.11)	18 (1.90)	4.2 (1.55, 11.37)	0.0047	3.75 (1.21, 11.59)	0.0218
Never	30 (40.54)	378 (39.92)	(REF)		(REF)
Unknown	21 (28.38)	389 (41.08)	0.68 (0.38, 1.21)	0.1893	0.51 (0.25, 1.04)	0.0647
Clinical characteristics
Anxiety
Yes	14 (18.92)	91 (9.61)	2.20 (1.18, 4.08)	0.0130	2.76 (1.31, 5.81)	0.0074
No	60 (81.08)	856 (90.39)	(REF)		(REF)
Depression
Yes	12 (16.22)	53 (5.60)	3.27 (1.66, 6.43)	0.0006	4.07 (1.80, 9.20)	0.0007
No	62 (83.78)	894 (94.40)	(REF)		(REF)
IBD type
Crohn’s disease	42 (56.76)	442 (46.67)	0.67 (0.41, 1.08)	0.0961	--	--
Ulcerative colitis	32 (43.24)	505 (53.33)	(REF)		--	--
CCI
Mean (SD)	1.35 (2.35)	2.23 (2.90)	0.87 (0.78, 0.97)	0.0124	0.97 (0.83, 1.13)	0.7044

Table: Table 1. Association between pre-admission characteristics and cannabis use (N=1021)

Disclosures:

Ellen Oseni indicated no relevant financial relationships.

Miriam Blumenthal indicated no relevant financial relationships.

Michael Qiu indicated no relevant financial relationships.

Stephanie Izard indicated no relevant financial relationships.

Anjali Mone indicated no relevant financial relationships.

Arun Swaminath: BI – Advisory Committee/Board Member. BMS – Advisory Committee/Board Member. Janssen – Grant/Research Support. Takeda – Grant/Research Support.

Keith Sultan indicated no relevant financial relationships.

Ellen Oseni, MD¹, Miriam Blumenthal, ¹, Michael Qiu, ¹, Stephanie Izard, ¹, Anjali Mone, MD², Arun Swaminath, MD³, Keith Sultan, MD⁴. E0350 - Factors Associated With Cannabis Use Among Inpatients With Inflammatory Bowel Disease Exacerbation, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.