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Sandhyavenu H, Patel HP, Patel RH, Desai R, Patel AA, Patel BA, Patel J, Zahid S, Khan SU, Deshmukh A, Nasir K, DeSimone CV, Dani SS, Thakkar S. Rising trend of acute myocardial infarction among young cannabis users: A 10-year nationwide gender and race stratified analysis. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2023; 16:200167. [PMID: 36874042 PMCID: PMC9975233 DOI: 10.1016/j.ijcrp.2022.200167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
Background The use of cannabis has massively increased among younger patients due to increasing legalization and availability. Methods We performed a retrospective nationwide study using the Nationwide inpatient sample (NIS) database to analyze the trends of acute myocardial infarction (AMI) in young cannabis users and related outcomes among patients aged 18-49 years from 2007 to 2018, using ICD-9 and ICD-10 codes. Results Out of 819,175 hospitalizations, 230,497 (28%) admissions reported using cannabis. There was a significantly higher number of males (78.08% vs. 71.58%, p < 0.0001) and African Americans (32.22% vs. 14.06%, p < 0.0001) admitted with AMI and reported cannabis use. The incidence of AMI among cannabis users consistently increased from 2.36% in 2007 to 6.55% in 2018. Similarly, the risk of AMI in cannabis users among all races increased, with the biggest increase in African Americans from 5.69% to 12.25%. In addition, the rate of AMI in cannabis users among both sexes showed an upward trend, from 2.63% to 7.17% in males and 1.62%-5.12% in females. Conclusion The incidence of AMI in young cannabis users has increased in recent years. The risk is higher among males and African Americans.
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Affiliation(s)
| | - Harsh P Patel
- Department of Internal Medicine, Louis A Weiss Memorial Hospital, Chicago, IL, USA
| | - Riddhiben H Patel
- Department of Internal Medicine, HCA Medical City Arlington, Dallas, Tx, USA
| | - Rohan Desai
- Department of Internal Medicine, Texas Tech University Health Science Center El Paso, El Paso, Tx, USA
| | - Achint A Patel
- Department of Public Health, Icahn School of Medicine Mount Sinai, New York, NY, USA
| | - Bhavin A Patel
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Jaimin Patel
- Department of Internal Medicine, GCS Medical College, Gujarat, India
| | - Salman Zahid
- Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
| | - Safi U Khan
- Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tx, USA
| | - Abhishek Deshmukh
- Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA
| | - Khurram Nasir
- Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tx, USA
| | | | - Sourbha S Dani
- Department of Cardiology, Lahey Hospital & Medical Center, Burlington, MA, USA
| | - Samarthkumar Thakkar
- Department of Cardiovascular Medicine, Houston Methodist DeBakey Heart and Vascular Center, Houston, Tx, USA
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Sulley S, Ndanga M, Saka AK. Prevalence of Cannabis Use and Factors Related to Hospitalizations in the United States: A Population-Based Study Using National Inpatient Sample Between 2012 and 2018. Cureus 2022; 14:e28361. [PMID: 36168355 PMCID: PMC9507936 DOI: 10.7759/cureus.28361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction: Cannabis use has been associated with adverse outcomes among adults and adolescents. As more states legalize or consider legalization, it is imperative to understand cannabis-related hospitalizations among the US population. This study is aimed at understanding the prevalence of cannabis-related hospitalizations using a nationally representative sample. Methods: Using the National Inpatient Sample (NIS) available through the Healthcare Cost and Utilization Project (HCUP), we included all hospitalizations that met the inclusion criteria of documented history of cannabis use and those with any cannabis diagnosis as the reason for hospitalization between 2012 and 2014, and 2016 and 2018 using listwise deletion methods. Cannabis use was identified based on International Classification of Disease (ICD 9 & 10) codes (304.3X, 305.2X) (F12.XXX) for 2012-2014 and 2016-2018, respectively. We included both primary and secondary diagnoses among hospitalized patients. We further analyzed the relationship between cannabis-related diagnoses, race and ethnicity cases, household income, region, age group, rural-urban demographics, and sex. Results: A weighted total of 2,099,665 and 1,023,325 patients with a history of cannabis use were identified for the period of 2012-2014 and 2016-2018, respectively. The primary reason for presentation among a majority of patients was related to mental health, alcohol, HIV, trauma, burns, and toxic effects of drugs for all included years. The rate of the presentation was highest among individuals 12-24-years-old (351, 846) and 25-34-years-old (255 and 563) per 10,000 presentations between 2012-2014 and 2016-2018, respectively. The highest rate of increase by race and ethnicity was observed among Native Americans (227 and 457), Black (287 and 468), and others (125 and 214) during 2012-2014 and 2016-2018, respectively. The highest observations were in the East North Central, West North Central, Mountain, and Pacific Regions of the United States. The highest presentation rates were observed among males with no insurance coverage and populations in the lowest income quartiles. Conclusion: Cannabis-related hospitalization increased significantly over the years, and presentations are not isolated to areas with cannabis legalization. The high presentation rate among individuals with mental and alcohol necessitates the development of strategies to educate and mitigate potential causes of hospitalization among all age groups and races or ethnicity.
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Ladha KS, Mistry N, Wijeysundera DN, Clarke H, Verma S, Hare GMT, Mazer CD. Recent cannabis use and myocardial infarction in young adults: a cross-sectional study. CMAJ 2021; 193:E1377-E1384. [PMID: 34493564 PMCID: PMC8443297 DOI: 10.1503/cmaj.202392] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Cannabis use is increasing among young adults, but its effects on cardiovascular health are poorly understood. We aimed to assess the association between recent cannabis use and history of myocardial infarction (MI) in young adults (aged 18-44 yr). METHODS We performed a cross-sectional study using pooled data from the 2017 and 2018 cohorts of the American Behavioral Risk Factor Surveillance System survey of US adults. We analyzed the association between any recent cannabis use and history of MI using a weighted logistic regression model that adjusted for demographic factors, socioeconomic factors, health-related behaviours, concomitant substance use and other comorbidities. We also assessed this association after stratifying by frequency of use and by primary method of consumption. RESULTS Among 33 173 young adults (18.5 million weighted), 4610 respondents (3.2 million weighted) reported recent cannabis use (17.5%, 95% confidence interval [CI] 16.8%-18.2%). A history of MI was more frequent among recent cannabis users (n = 61 of 4610, 1.3%) relative to nonusers (n = 240 of 28 563 [0.8%], adjusted odds ratio [OR] 2.07, 95% CI 1.12-3.82). A history of MI was associated with cannabis use of more than 4 times per month (adjusted OR 2.31, 95% CI 1.18-4.50), and with smoking as a primary method of consumption (adjusted OR 2.01, 95% CI 1.02-3.98). INTERPRETATION Our study provides evidence supporting an association between recent cannabis use and history of MI in young adults. Increasing cannabis use in an at-risk population could have negative implications for cardiovascular health.
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Affiliation(s)
- Karim S Ladha
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont
| | - Nikhil Mistry
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont
| | - Duminda N Wijeysundera
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont
| | - Hance Clarke
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont
| | - Subodh Verma
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont
| | - Gregory M T Hare
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont
| | - C David Mazer
- Department of Anesthesia (Ladha, Mistry, Wijeysundera, Hare, Mazer), St. Michael's Hospital, Unity Health Toronto and Institute of Health Policy, Management, and Evaluation (Ladha, Wijeysundera) and Institute of Medical Sciences (Mistry, Mazer) and Department of Anesthesia and Pain Management, Toronto General Hospital, University Health Network (Clarke) and Division of Cardiac Surgery (Verma), St. Michael's Hospital, Unity Health Toronto and Department of Surgery (Verma) and Department of Physiology (Hare, Mazer), University of Toronto, Toronto, Ont.
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Abstract
PURPOSE OF REVIEW In recent decades, the incidence of myocardial infarction (MI) has declined among the general population. However, MI rates in the young have not decreased as much as has been observed among older individuals. This review will focus on recent trends of MI in young patients, factors that may account for these trends, and implications for future prevention. RECENT FINDINGS MI rates in young patients, particularly in women, have not decreased in the same fashion as they have for their older counterparts, with some studies reporting an increase. The reasons for these findings include underestimation of cardiovascular risk, and accordingly treatment, in the young, as well as an increasing prevalence of risk factors such as obesity and diabetes. SUMMARY Better recognition and treatment of cardiovascular risk factors among young adults may improve outcomes. There is a need for improved methods to assess and treat cardiovascular risk in young individuals.
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Ravat V, Ajibawo T, Parvataneni T, Pereira KN, Yen TY, Patel RS. National Trends of Arrhythmia Hospitalizations and Comorbid Alcohol Use Disorders in the United States. Cureus 2020; 12:e8835. [PMID: 32742846 PMCID: PMC7384718 DOI: 10.7759/cureus.8835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objective To study the trends of arrhythmia hospitalizations with comorbid alcohol use disorders (AUDs) in terms of demographic characteristics and inpatient outcomes. Methods We used the Nationwide Inpatient Sample (NIS) data from 2010 to 2014 and included 570,556 arrhythmia inpatients (age, 15-54 years), and 55,730 inpatients had comorbid AUD. We used the linear-by-linear association test for measuring the differences in demographics, comorbidities, and hospital outcomes over the study period of 2010 to 2014, and the analysis of variance (ANOVA) for measuring the changes seen in the length of stay (LOS) and total charges. Results Arrhythmia inpatients with AUD were majorly males (85.9%), and older-age adults (45 to 54 years, 68%). Hypertension (52.2%), tobacco abuse (42.3%), and elevated cholesterol and lipids (22.6%) were the most prevalent comorbidities in the study population. There was a statistically significant increasing trend in arrhythmia inpatients with AUD with comorbid diabetes, hypertension, and obesity over the five-year period. In-hospital mortality had a variable trend from 1.1% in 2010 to 1.3% in 2014, but there was a statistically non-significant difference in the trend (P = 0.418). Mean LOS was three days with statistically no significant change during the study period (P = 0.080), whereas total charges have been increasing significantly (P <0.001), averaging $37,473 per hospitalization. Conclusion The prevalence trend of arrhythmia hospitalizations with comorbid AUD is increasing in the United States population, and is majorly seen in older-age men. Overall, in-hospital mortality in arrhythmia inpatients with comorbid AUD was 1.4%. So, this necessitates the development of an integrated clinical care model for early diagnosis and management of alcohol abuse and dependence in order to improve the arrhythmia patient outcomes and quality of life.
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Affiliation(s)
| | - Temitope Ajibawo
- Internal Medicine, Brookdale University Hospital Medical Center, New York City, USA
| | - Tarun Parvataneni
- Psychiatry, Siddavanahalli Nijalingappa Medical College and HSK Hospital and Research Centre, Bagalkot, IND
| | | | - Ting Yu Yen
- Medicine, Poznan University of Medical Sciences, Poznan, POL
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Patel RS, Goyal H, Satodiya R, Tankersley WE. Relationship of Cannabis Use Disorder and Irritable Bowel Syndrome (IBS): An Analysis of 6.8 Million Hospitalizations in the United States. Subst Use Misuse 2020; 55:281-290. [PMID: 31573379 DOI: 10.1080/10826084.2019.1664591] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Background: Irritable bowel syndrome (IBS) is a chronic multifactorial gastrointestinal condition that substantially affects the quality of life. Research have suggested an increasing trend in cannabis use to alleviate IBS-related psychiatric symptoms. Objectives: We aim to investigate the association of psychiatric comorbidities and cannabis use disorders (CUD) in hospitalized IBS patients. Methods: We analyzed 31,272 IBS hospitalizations in patients (aged 15-54 years) from the Nationwide Inpatient Sample (NIS). We utilized logistic regression to evaluate the adjusted odds ratio (aOR) of CUD and psychiatric comorbidities. Results: Anxiety (26.3%) and depressive (24.8%) disorders were prevalent and increased the odds for IBS-hospitalization by 2.5 and 1.8 times respectively. Tobacco use disorder was most prevalent (24.5%) followed by CUD (3.7%). After controlling for demographics, psychiatric and medical comorbidities, and other substance use disorders, CUD had higher odds for IBS hospitalizations (aOR 1.407, 95% CI 1.32-1.50). IBS hospitalizations with CUD increased by 32.8% from 2010 to 2014. CUD patients were younger (15-24 years, aOR 5.4, 95% CI 4.27-6.77), males (aOR 1.8, 95% CI 1.59-2.09) and African Americans (aOR 2.8, 95% CI 1.45-2.23) and from low-income families (aOR 1.9, 95% CI 1.58-2.39). Conclusions: We found that patients with CUD have 40.7% higher odds for IBS-hospitalizations with a rising trend of CUD and related psychiatric comorbidities which may further worsen IBS and health quality of life. With limited evidence of efficacy and safety of cannabis in IBS, larger, randomized controlled studies are required to examine its therapeutic efficacy.
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Affiliation(s)
- Rikinkumar S Patel
- Department of Psychiatry, Griffin Memorial Hospital and Oklahoma Department of Mental Health and Substance Abuse (Odmhas), Norman, OK, USA
| | - Hemant Goyal
- Department of Gastroenterology & Hepatology, The Wright Center of Graduate Medical Education, Scranton, PA, USA
| | - Ritvij Satodiya
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - William E Tankersley
- Department of Psychiatry, Griffin Memorial Hospital and Oklahoma Department of Mental Health and Substance Abuse (Odmhas), Norman, OK, USA
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What Have Been the Public Health Impacts of Cannabis Legalisation in the USA? A Review of Evidence on Adverse and Beneficial Effects. CURRENT ADDICTION REPORTS 2019. [DOI: 10.1007/s40429-019-00291-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Jaladi PR, Patel V, Kuduva Rajan S, Rashid W, Madireddy S, Ajibawo T, Imran S, Patel RS. Arrhythmia-related Hospitalization and Comorbid Cannabis Use Disorder: Trend Analysis in US Hospitals (2010-2014). Cureus 2019; 11:e5607. [PMID: 31700720 PMCID: PMC6822885 DOI: 10.7759/cureus.5607] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objective To study the trends of arrhythmia hospitalizations with cannabis use disorders (CUDs) in terms of demographic characteristics and inpatient outcomes. Methods We used the nationwide inpatient sample (NIS) data during the post-legalization period (2010-2014) and included 570,556 arrhythmia inpatients (age, 15-54 years), and 14,426 inpatients had comorbid CUD (2.53%). We used the linear-by-linear association test and independent-sample T-test for assessing the change in hospital outcomes in inpatients with CUD. Results Arrhythmia hospitalizations with CUD increased by 31% (2010-2014). This increasing trend was seen in adults (45-54 years, P < 0.001) and was predominant in males (77.6%). Hypertension (40.6%), hyperlipidemia (17.6%), and obesity (15%) were prevalent medical comorbidities with variable trends over the five years. Among substance use disorders, tobacco (50.9%), and alcohol (31.4%) were major comorbidities with a variable trend (P = 0.003 for each). There was a 71.4% increase in the inpatient mortality rate between 2010 (0.7%) and 2014 (1.2%). The mean length of stay was three days, and the total hospitalization charges have been increasing (P < 0.001), averaging $35,812 per hospital admission. Conclusion Chronic cannabis use or abuse worsens hospitalization outcomes in arrhythmic patients, and more clinical studies are needed to study the causal association between these conditions due to the rising mortality risk.
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Affiliation(s)
- Paul Rahul Jaladi
- Internal Medicine, Rajiv Gandhi Institute of Medical Sciences, Kadapa, IND
| | | | | | - Wahida Rashid
- Internal Medicine, Dhaka Medical College, Dhaka, BGD
| | | | - Temitope Ajibawo
- Internal Medicine, Brookdale University Hospital and Medical Center, New York, USA
| | - Sundus Imran
- Neurology, Indiana University School of Medicine, Indianapolis, USA
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Madireddy S, Patel RS, Ravat V, Ajibawo T, Lal A, Patel J, Patel R, Goyal H. Burden of Comorbidities in Hospitalizations for Cannabis Use-associated Intractable Vomiting during Post-legalization Period. Cureus 2019; 11:e5502. [PMID: 31511820 PMCID: PMC6716962 DOI: 10.7759/cureus.5502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective The aim of this study was to observe the trends of intractable vomiting and cannabis use disorder (CUD) with demographic characteristics, medical and psychiatric comorbidities, and hospitalization outcomes. Methods We conducted a retrospective cohort study using the nationwide inpatient sample (2010 to 2014). Patients aged 16-50 years discharged with a primary diagnosis of intractable vomiting and CUD were included (N = 9,601). We used the linear-by-linear association chi-square test and independent-sample T-test for measuring the categorical and continuous data, respectively. Results The number of intractable vomiting hospitalizations with CUD had an increasing trend (P < 0.001) with a 28.6% increase over five years. About half of the study population included young (16-30 years, 48.4%) males (57.2%). There was a decreasing trend (P = 0.041) in the prevalence of intractable vomiting with CUD in non-Hispanic Whites and Blacks, whereas there was 778% increase in Hispanics. The mean length of stay was 3.2 days which had a decreasing linear trend, and total hospital charges showed an increasing trend (P < 0.001), averaging $22,890. Electrolyte disorders (55.3%), hypertension (25.3%), chronic lung disease (11.9%), and deficiency anemia (10.3%) constituted the majority of comorbidities, with anemia showing a statistically significant increasing trend (P = 0.004). Anxiety disorders increased from 20.8% to 30.8% over five years, whereas depression decreased from 19.2% to 16.4% (P < 0.001). Concomitant tobacco abuse/dependence was present in 41.2% of patients with CUD. Conclusion The results of our study show that the intractable vomiting hospitalizations related to CUD have increased significantly over a five-year period. The general public and healthcare practitioners should be made aware of the paradoxical gastrointestinal side effects of cannabis.
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Affiliation(s)
| | | | | | - Temitope Ajibawo
- Internal Medicine, Brookdale University Hospital and Medical Center, New York, USA
| | - Anthony Lal
- Internal Medicine, Windsor University Medical School, Basseterre, KNA
| | - Jenil Patel
- Epidemiology, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Riddhi Patel
- Epidemiology, The University of Texas School of Public Health at Houston, Houston, USA
| | - Hemant Goyal
- Department of Gastroenterology & Hepatology, The Wright Center of Graduate Medical Education, Scranton, Pa, Scranton, USA
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Rashid W, Patel V, Ravat V, Madireddy S, Jaladi PR, Tahir M, Bhimanadham NN, Kuduva Rajan S, Imran S, Patel RS. Problematic Cannabis Use and Risk of Complications in Patients with Chronic Hepatitis C. Cureus 2019; 11:e5373. [PMID: 31431849 PMCID: PMC6697459 DOI: 10.7759/cureus.5373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Objectives To evaluate the risk of complication in hospitalized chronic hepatitis C (CHC), patients with cannabis use disorder (CUD). Methods We conducted a retrospective study using the nationwide inpatient sample (NIS), and included 31,623 patients (age 15-54) with a primary international classification of diseases, ninth revision (ICD-9) diagnosis for CHC and grouped by co-diagnosis of CUD (1101, 3.5%). Logistic regression model adjusted for confounders was used to evaluate the odds ratio (OR) of CUD and complications during CHC hospitalization. Results Comorbid CUD was prevalent in males (73.2%), Caucasians (59.9%), and from low-income families (65.7%). The most prevalent complications in patients with CUD were ascites (44.9%), alcoholic cirrhosis (42.8%) and non-alcoholic cirrhosis (41.1%). The odds of association for hepatic encephalopathy was 2.2 times higher (95% CI 1.477-3.350) in 2.8% CHC inpatients with CUD compared to 1.2% non-CUD inpatients. Hepatic encephalopathy had higher odds of association with a male by 1.4 times (95% CI 1.094-1.760), and African American by 1.7 times (95% CI 1.293-2.259). Conclusion CUD is significantly associated with 122% increased likelihood for hepatic encephalopathy that may worsen overall hospitalization outcomes in CHC patients. Hence, we need to consider the complex relationship between CUD and CHC and manage them optimally to improve the health-related quality of life.
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Affiliation(s)
- Wahida Rashid
- Internal Medicine, Dhaka Medical College, Dhaka, BGD
| | | | | | | | - Paul Rahul Jaladi
- Internal Medicine, Rajiv Gandhi Institute of Medical Sciences, Kadapa, IND
| | - Muhammad Tahir
- Internal Medicine, Penn Medicine Lancaster General Hospital, Lancaster, USA
| | | | | | - Sundus Imran
- Neurology, Indiana University School of Medicine, Indianapolis, USA
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Roberts BA. Legalized Cannabis in Colorado Emergency Departments: A Cautionary Review of Negative Health and Safety Effects. West J Emerg Med 2019; 20:557-572. [PMID: 31316694 PMCID: PMC6625695 DOI: 10.5811/westjem.2019.4.39935] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 11/11/2022] Open
Abstract
Cannabis legalization has led to significant health consequences, particularly to patients in emergency departments and hospitals in Colorado. The most concerning include psychosis, suicide, and other substance abuse. Deleterious effects on the brain include decrements in complex decision-making, which may not be reversible with abstinence. Increases in fatal motor vehicle collisions, adverse effects on cardiovascular and pulmonary systems, inadvertent pediatric exposures, cannabis contaminants exposing users to infectious agents, heavy metals, and pesticides, and hash-oil burn injuries in preparation of drug concentrates have been documented. Cannabis dispensary workers (“budtenders”) without medical training are giving medical advice that may be harmful to patients. Cannabis research may offer novel treatment of seizures, spasticity from multiple sclerosis, nausea and vomiting from chemotherapy, chronic pain, improvements in cardiovascular outcomes, and sleep disorders. Progress has been slow due to absent standards for chemical composition of cannabis products and limitations on research imposed by federal classification of cannabis as illegal. Given these factors and the Colorado experience, other states should carefully evaluate whether and how to decriminalize or legalize non-medical cannabis use.
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Affiliation(s)
- Brad A Roberts
- University of New Mexico, Department of Emergency Medicine, Albuquerque, New Mexico Partner, Southern Colorado Emergency Medicine Associates, Pueblo, Colorado
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