P1761 - The Cannabis Conundrum: Does Cannabis Use Worsen Clinical Outcomes in Acute Pancreatitis? A Propensity-Matched Nationwide Analysis

Mihir P. Shah, MD¹, Bhanu Siva Mohan Pinnam, MD², Madhav Changela, MD³, Daniel Guifarro, MD², Muhammad Bilal, MD², Daksh Ahluwalia, MD², Raja Chandra Chakinala, MD⁴, Seema Gandhi, MD^2
1John H. Stroger, Jr. Hospital of Cook County, Cook County, IL; ²John H. Stroger, Jr. Hospital of Cook County, Chicago, IL; ³One Brooklyn Health-Interfaith Medical Center, Brooklyn, NY; ⁴Guthrie Robert Packer Hospital, Sayre, PA

Introduction: Cannabis is the most widely used illicit drug worldwide. With the legalization of recreational marijuana in many US states and the increased use of cannabis in recent years, there is a need for increased research on the health effects of cannabis use. There have been limited large-scale studies on its impact on acute pancreatitis. We assessed the impact of cannabis use on the clinical outcomes of patients admitted with acute pancreatitis.

Methods: The National Inpatient Sample (NIS) 2016-2021 was queried to identify patients admitted with a primary diagnosis of acute pancreatitis. These patients were divided into two groups depending on concomitant cannabis use. In-hospital mortality, healthcare utilization, and other secondary outcomes were compared between the two groups. Initial analysis was performed using multivariate regression analysis to adjust for confounders. Subsequently, propensity score matching was used to match patients one-to-one.

Results: There was a total of 16.4 million hospitalizations for acute pancreatitis, with 77,580 of them being cannabis users. There was an upward trend in the percentage of acute pancreatitis patients having cannabis use from 2016 to 2021. Cannabis users were more likely to be younger (41.2 vs 52.1 years), males (67.1% vs 53.3%), African Americans (29.6% vs 16%), and on Medicaid insurance (46.4% vs 25.1%). They were also more likely to have concomitant tobacco use (76.3% vs 48.2%) and alcohol use (57.3% vs 30.9%). Cannabis users had lower odds of mortality (OR 0.38), sepsis (OR 0.59), shock (OR 0.39), ileus (OR 0.72), need for blood transfusions (OR 0.69), pancreatic drainage (OR 0.65) acute respiratory failure (OR 0.53), and need for ICU stay (OR 0.46); while having higher odds of GI bleeding (OR 1.18), acute myocardial infarction (OR 1.63), exocrine pancreatic insufficiency (OR 1.45), pancreatic pseudocysts (OR 1.19). There was no difference in odds of PE, DIC, or undergoing EGD and ERCP. All these results were statistically significant.

Discussion: Cannabis use led to higher odds of local pancreatic complications; however, these were not significant enough to increase the need for GI procedures. These complications also did not translate into higher odds of mortality or major systemic complications. Younger age and lower likelihood of traditional comorbidities in the cannabis group also likely contribute to these findings. Patients should be counseled on cannabis abstinence to reduce the chances of local complications with future episodes.



Disclosures:


Mihir P. Shah, MD¹, Bhanu Siva Mohan Pinnam, MD², Madhav Changela, MD³, Daniel Guifarro, MD², Muhammad Bilal, MD², Daksh Ahluwalia, MD², Raja Chandra Chakinala, MD⁴, Seema Gandhi, MD². P1761 - The Cannabis Conundrum: Does Cannabis Use Worsen Clinical Outcomes in Acute Pancreatitis? A Propensity-Matched Nationwide Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.