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The Impact of Cannabis Consumption on Mortality, Morbidity, and Cost in Acute Pancreatitis Patients in the United States

A 10-Year Analysis of the National Inpatient Sample

Simons-Linares, Carlos Roberto MD, MSc*; Barkin, Jodie A. MD; Jang, Sunguk MD*; Bhatt, Amit MD*; Lopez, Rocio MS, MPH*; Stevens, Tyler MD*; Vargo, John MD, MPH, FACG, FASGE*; Barkin, Jamie S. MD, MACP, MACG, AGAF, FACG*; Chahal, Prabhleen MD, FACG, FASGE*

doi: 10.1097/MPA.0000000000001343
Original Articles
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Objectives The aim of this study was to identify the prevalence of cannabis use among all patients admitted with acute pancreatitis (AP) in the United States and to investigate the impact of cannabis use on AP mortality, morbidity, and cost of care.

Methods The National Inpatient Sample database from 2003 to 2013 was queried for all patients with AP and active exposure to cannabis. Outcomes included in-hospital mortality, length of stay, inflation adjusted charges, acute kidney injury, acute respiratory distress syndrome, and shock. Results were adjusted for age, sex, race, Charlson comorbidity index, median income quartile, and hospital characteristics.

Results More than 2.8 million patients with AP patients were analyzed. Cannabis-exposed (CE) patients' prevalence was 0.3%. Patients exposed to cannabis were younger and mostly males compared with non–cannabis-exposed patients. After adjusting for these factors, the CE group had significantly lower inpatient mortality compared with the noncannabis group (odds ratio, 0.17; 95% confidence interval, 0.06–0.53). Cannabis-exposed patients also had decreased length of stay, inflation-adjusted charges, acute kidney injury, ileus, shock, acute respiratory distress syndrome, and parenteral nutrition requirement.

Conclusions Cannabis-exposed hospitalized patients with AP had lower age-adjusted, mortality, morbidity, and hospitalization-cost than non–cannabis-exposed patients.

From the *Gastroenterology and Hepatology Department, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH; and

Division of Gastroenterology, Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL.

Received for publication November 9, 2018; accepted April 26, 2019.

Address correspondence to: Prabhleen Chahal, MD, FACG, FASGE, Gastroenterology and Hepatology Department, Digestive Disease Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195 (e-mail: chahalp@ccf.org); C. Roberto Simons-Linares, MD, MSc, Gastroenterology and Hepatology Department, Digestive Disease Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195 (e-mail: robertosimons@outlook.com).

The authors declare no conflict of interest.

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