P2900 - Higher Prevalence but Lower Mortality in Acute Liver Failure-Related Hospitalizations in Elderly Cohort With Cannabis Use Disorder: A Population Based Analysis

Akhila Reddy Radhareddy, MBBS¹, Vijaya Rupa Konakanchi, MBBS², Vihar Podduturi, MBBS³, Lalitkumar Patel, MBBS⁴, Priyanka Mohnani, MBBS⁵, Thiruvikram Sivakumar, MBBS⁶, Shreyjit Kaur, MBBS⁷, Zoofi Shan, MBBS⁸, Rupak Desai, MBBS^9
1MediCiti Institute of Medical Sciences, Medchal, Telangana, India; ²Bhaskar Medical College and General Hospital, Hyderabad, Telangana, India; ³Kamineni Institute of Medical Sciences, Hyderabad, Telangana, India; ⁴Suburban Medical Center, Schaumburg, IL; ⁵Government Medical College, Surat, Gujarat, India; ⁶SRM Medical College Hospital and Research Centre, Kattankulathur, Tamil Nadu, India; ⁷Government Medical College, Patiala, Punjab, India; ⁸Sri Guru Ram Das Institute of Medical Sciences and Research, Vallah Sri, Punjab, India; ⁹Outcomes Research, Atlanta, GA

Introduction: With increasing cannabis use among elderly populations, understanding its impact on Acute liver failure (ALF) outcomes is crucial. This study examines the relationship between Cannabis use disorder (CUD) and hospitalization outcomes in elderly ALF patients, focusing on prevalence, trends, and assessing the impact on in-hospital outcomes, including all-cause mortality.

Methods: We analyzed the NIS from 2016 to 2020, focusing on elderly patients (age ≥ 65 years) with ALF. The study population was patients with CUD and without CUD. The diagnoses of ALF and CUD were identified using relevant ICD-10-CM codes. We employed statistical methods such as p-trend analysis for trends, and Chi-square and Mann-Whitney U tests for categorical and continuous data respectively. Multivariable logistic regression analysis was performed adjusting for confounders to evaluate association between CUD and ALF.

Results: Out of the total 64,554,385 study population, 718,050 (1.1%) had ALF, of whom 3,295 (1.4%) had CUD. The prevalence of ALF-related hospitalizations is higher in CUD vs non-CUD groups (1.4% vs 1.1%, p< 0.001), however, when adjusted for confounders the ALF related hospitalizations were lower in CUD than non-CUD (0.74, 0.68-0.81, p< 0.001). The prevalence of ALF-related admissions with CUD decreased from 2016 to 2018 (1.5% vs 1.3%) but increased in 2019 (1.5%) and decreased again in 2020 (1.4 %) (p=0.521). In contrast, the prevalence of ALF admissions without CUD increased linearly from 2016 to 2020(p< 0.001). In-hospital mortality among ALF patients with CUD was 18.8% compared to 28.6% in the non-CUD group (0.79, 0.64-0.98, p=0.034). All-cause mortality was lower in CUD group without tobacco use disorder (TUD) and without alcohol use disorder (AUD) (0.74, 0.58-0.95, p=0.020), similar to CUD group without TUD and with AUD (0.88, 0.59-1.31, p=0.528).

Discussion: The study found a higher prevalence of ALF-related hospitalizations among elderly patients with CUD. Despite the higher prevalence, the mortality rate among ALF patients with CUD was lower compared to non-users, possibly due to the endocannabinoid system's role in reducing liver inflammation and fibrosis. These findings suggest a need for further research on the effects of cannabinoids in liver diseases, particularly in elderly populations with chronic habitual cannabis use.


Disclosures:


Akhila Reddy Radhareddy, MBBS¹, Vijaya Rupa Konakanchi, MBBS², Vihar Podduturi, MBBS³, Lalitkumar Patel, MBBS⁴, Priyanka Mohnani, MBBS⁵, Thiruvikram Sivakumar, MBBS⁶, Shreyjit Kaur, MBBS⁷, Zoofi Shan, MBBS⁸, Rupak Desai, MBBS⁹. P2900 - Higher Prevalence but Lower Mortality in Acute Liver Failure-Related Hospitalizations in Elderly Cohort With Cannabis Use Disorder: A Population Based Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.