Association of Cannabis Use Disorder With Hospitalizations for Pulmonary Embolism and Subsequent in‐Hospital Mortality in Young Adults: A Contemporary Nationwide Analysis

Background With the increase in popularity of cannabis and its use and the lack of large‐scale data on cannabis use and venous thromboembolism and pulmonary embolism (PE), we used a nationally representative cohort of young adults (aged 18–44 years) to compare the odds of admissions and in‐hospital...

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Main Authors: Rupak Desai, Nitin Ghadge, Sai Gautham Kanagala, Nishanth Katukuri, Alpha James, Avinash Kadiyala, Sai Diksha Vutukuru, Meghana Kotharu, Tajdin Borzoo, Akhila Nalla, Ankit Vyas, Shivani Priyadarshni, Mostafa Shalaby, Wissam Khalife
Format: Article
Language:English
Published: Wiley 2024-07-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.123.032787
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author Rupak Desai
Nitin Ghadge
Sai Gautham Kanagala
Nishanth Katukuri
Alpha James
Avinash Kadiyala
Sai Diksha Vutukuru
Meghana Kotharu
Tajdin Borzoo
Akhila Nalla
Ankit Vyas
Shivani Priyadarshni
Mostafa Shalaby
Wissam Khalife
author_facet Rupak Desai
Nitin Ghadge
Sai Gautham Kanagala
Nishanth Katukuri
Alpha James
Avinash Kadiyala
Sai Diksha Vutukuru
Meghana Kotharu
Tajdin Borzoo
Akhila Nalla
Ankit Vyas
Shivani Priyadarshni
Mostafa Shalaby
Wissam Khalife
author_sort Rupak Desai
collection DOAJ
description Background With the increase in popularity of cannabis and its use and the lack of large‐scale data on cannabis use and venous thromboembolism and pulmonary embolism (PE), we used a nationally representative cohort of young adults (aged 18–44 years) to compare the odds of admissions and in‐hospital mortality of PE with and without cannabis use disorder (CUD). Methods and Results Identified patients with PE using the National Inpatient Sample (2018) were compared for baseline, comorbidities, and outcomes. Multivariable regression analysis, adjusted for covariates, was used to compare the odds of PE in young patients with CUD (CUD+) versus those without (CUD−) and those with prior venous thromboembolism. Propensity score–matched analysis (1:6) was also performed to assess in‐hospital outcomes. A total of 61 965 (0.7%) of 8 438 858 young adult admissions in 2018 were PE related, of which 1705 (0.6%) had CUD+. On both unadjusted (odds ratio, 0.80 [95% CI, 0.71–0.90]; P<0.001) and adjusted regression analyses, the CUD+ cohort had a lower risk of PE admission. The CUD+ cohort had fewer routine discharges (58.3% versus 68.3%) and higher transfers to short‐term (7.9% versus 4.8%) and nursing/intermediate care (12.6% versus 9.5%) (P<0.001). The PE‐CUD+ cohort of in‐hospital mortality did not differ from the CUD− cohort. Propensity score–matched (1:6) analysis revealed comparable mortality odds with higher median hospital stay and cost in the CUD+ cohort. Conclusions Young adults with CUD demonstrated lower odds of PE hospitalizations without any association with subsequent in‐hospital mortality. The median hospital stay of the CUD+ cohort was longer, they were often transferred to other facilities, and they had a higher cost.
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spelling doaj-art-8aecd1e8853c4e7a9ef7aa46da5904ff2025-08-20T02:26:33ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-07-01131310.1161/JAHA.123.032787Association of Cannabis Use Disorder With Hospitalizations for Pulmonary Embolism and Subsequent in‐Hospital Mortality in Young Adults: A Contemporary Nationwide AnalysisRupak Desai0Nitin Ghadge1Sai Gautham Kanagala2Nishanth Katukuri3Alpha James4Avinash Kadiyala5Sai Diksha Vutukuru6Meghana Kotharu7Tajdin Borzoo8Akhila Nalla9Ankit Vyas10Shivani Priyadarshni11Mostafa Shalaby12Wissam Khalife13Independent Researcher Atlanta GANew York State Department of Health Albany NYMetropolitan Hospital Center New York NYDepartment of Internal Medicine Mayo Clinic Rochester MNBukovinian State Medical University Chernivitsi UkraineDeccan College of Medical Sciences Hyderabad Telangana IndiaM N Raju Medical College Sangareddy Telangana IndiaM N Raju Medical College Sangareddy Telangana IndiaShahid Beheshti University of Medical Sciences Tehran IranM N Raju Medical College Sangareddy Telangana IndiaDepartment of Vascular Medicine Ochsner Clinic Foundation New Orleans LADepartment of Cardiovascular Medicine University of Texas Medical Branch Galveston TXDepartment of Cardiovascular Medicine University of Texas Medical Branch Galveston TXDepartment of Cardiovascular Medicine University of Texas Medical Branch Galveston TXBackground With the increase in popularity of cannabis and its use and the lack of large‐scale data on cannabis use and venous thromboembolism and pulmonary embolism (PE), we used a nationally representative cohort of young adults (aged 18–44 years) to compare the odds of admissions and in‐hospital mortality of PE with and without cannabis use disorder (CUD). Methods and Results Identified patients with PE using the National Inpatient Sample (2018) were compared for baseline, comorbidities, and outcomes. Multivariable regression analysis, adjusted for covariates, was used to compare the odds of PE in young patients with CUD (CUD+) versus those without (CUD−) and those with prior venous thromboembolism. Propensity score–matched analysis (1:6) was also performed to assess in‐hospital outcomes. A total of 61 965 (0.7%) of 8 438 858 young adult admissions in 2018 were PE related, of which 1705 (0.6%) had CUD+. On both unadjusted (odds ratio, 0.80 [95% CI, 0.71–0.90]; P<0.001) and adjusted regression analyses, the CUD+ cohort had a lower risk of PE admission. The CUD+ cohort had fewer routine discharges (58.3% versus 68.3%) and higher transfers to short‐term (7.9% versus 4.8%) and nursing/intermediate care (12.6% versus 9.5%) (P<0.001). The PE‐CUD+ cohort of in‐hospital mortality did not differ from the CUD− cohort. Propensity score–matched (1:6) analysis revealed comparable mortality odds with higher median hospital stay and cost in the CUD+ cohort. Conclusions Young adults with CUD demonstrated lower odds of PE hospitalizations without any association with subsequent in‐hospital mortality. The median hospital stay of the CUD+ cohort was longer, they were often transferred to other facilities, and they had a higher cost.https://www.ahajournals.org/doi/10.1161/JAHA.123.032787cannabis/marijuanamortalityoutcomespulmonary embolismvenous thromboembolism
spellingShingle Rupak Desai
Nitin Ghadge
Sai Gautham Kanagala
Nishanth Katukuri
Alpha James
Avinash Kadiyala
Sai Diksha Vutukuru
Meghana Kotharu
Tajdin Borzoo
Akhila Nalla
Ankit Vyas
Shivani Priyadarshni
Mostafa Shalaby
Wissam Khalife
Association of Cannabis Use Disorder With Hospitalizations for Pulmonary Embolism and Subsequent in‐Hospital Mortality in Young Adults: A Contemporary Nationwide Analysis
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cannabis/marijuana
mortality
outcomes
pulmonary embolism
venous thromboembolism
title Association of Cannabis Use Disorder With Hospitalizations for Pulmonary Embolism and Subsequent in‐Hospital Mortality in Young Adults: A Contemporary Nationwide Analysis
title_full Association of Cannabis Use Disorder With Hospitalizations for Pulmonary Embolism and Subsequent in‐Hospital Mortality in Young Adults: A Contemporary Nationwide Analysis
title_fullStr Association of Cannabis Use Disorder With Hospitalizations for Pulmonary Embolism and Subsequent in‐Hospital Mortality in Young Adults: A Contemporary Nationwide Analysis
title_full_unstemmed Association of Cannabis Use Disorder With Hospitalizations for Pulmonary Embolism and Subsequent in‐Hospital Mortality in Young Adults: A Contemporary Nationwide Analysis
title_short Association of Cannabis Use Disorder With Hospitalizations for Pulmonary Embolism and Subsequent in‐Hospital Mortality in Young Adults: A Contemporary Nationwide Analysis
title_sort association of cannabis use disorder with hospitalizations for pulmonary embolism and subsequent in hospital mortality in young adults a contemporary nationwide analysis
topic cannabis/marijuana
mortality
outcomes
pulmonary embolism
venous thromboembolism
url https://www.ahajournals.org/doi/10.1161/JAHA.123.032787
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