Gastroparesis with Cannabis Use: A Retrospective Study from the Nationwide Inpatient Sample

ABSTRACT

Background: With increasing utilization of cannabis in the United States (US), clinicians may encounter more cases of Gastroparesis (GP) in coming years.

Objective: The primary outcome was inpatient mortality for GP with cannabis use. Secondary outcomes included system-based complications and the burden of the disease on the US healthcare system.

Methods: From the Nationwide Inpatient Sample (NIS), we identified adult hospitalizations with a primary discharge diagnosis of GP for 2016 and 2017. Individuals ≤18 years of age were excluded. The study population was subdivided based on a secondary diagnosis of cannabis use. The outcomes included biodemographic characteristics, mortality, complications, and burden of disease on the US healthcare system.

Results: For 2016 and 2017, we identified 99,695 hospitalizations with GP. Of these hospitalizations, 8,870 had a secondary diagnosis of cannabis use while 90,825 served as controls. The prevalence of GP with cannabis use was 8.9%. For GP with cannabis use, the patients were younger (38.5 vs 48.1 years, p < 0.001) with a Black predominance (Table 1) and lower proportion of females (52.3 vs 68.3%, p < 0.001) compared to the non-cannabis use cohort. Additionally, the cannabis use cohort had higher percentage of patients with co-morbidities like hypertension, diabetes mellitus and a history of smoking. The inpatient mortality for GP with cannabis use was noted to be 0.27%. Furthermore, we noted shorter mean length of stay (LOS) (3.4 vs 4.4 days, aMD: −0.7, 95%CI: −0.9 – [−0.5], p < 0.001), lower mean total hospital charge (THC) ($30,400 vs $38,100, aMD: −5100, 95%CI: −6900 – [−3200], p < 0.001), and lower rates of sepsis (0.11 vs 0.60%, aOR: 0.22, 95% CI: 0.05–0.91, p = 0.036) for GP hospitalizations with cannabis use compared to the non-cannabis use cohort.

Conclusion: Inpatient mortality for GP hospitalizations with cannabis use was 0.27%. Additionally, these patients had shorter LOS, lower THC, and lower sepsis rates.

KEYWORDS:

• Gastroparesis
• cannabis
• Marijuana
• esophageal disorders
• gastrointestinal motility
• hospitalization
• outcome

Declaration of funding

The authors have no funding sources to report.

Declaration of financial/other relationships

The authors report no conflict of interest. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Ethical approval

Our institution does not require ethical approval NIS data base studies.

Data availability statement

The NIS is one of the largest publicly available all-payer inpatient care databases in the US containing data on more than seven million hospital stays yearly. Its large sample size is ideal for developing national and regional estimates and enables analyses of rare conditions, uncommon treatments, and special populations. The NIS can be accessed at:  https://www.hcup-us.ahrq.gov/db/nation/nis/nisdbdocumentation.jsp

Availability of data and materials

We used and/or analyzed the NIS database 2016 & 2017, available online at http://www.hcup- us.ahrq.gov. The NIS is a large publicly available all-payer inpatient care database in the United States, containing data on more than seven million hospital stays yearly. Its large sample size is ideal for developing national and regional estimates and enables analyses of rare conditions, uncommon treatments, and special populations.

Author contributions statement

1. Conception and design: Dushyant Singh Dahiya, Asim Kichloo, Hafeez Shaka, Ehizogie Edigin

2. Administrative support: Dhanshree Solanki and Jagmeet Singh

3. Provision of data: Hafeez Shaka

4. Collection and assembly of data: Hafeez Shaka

5. Manuscript writing: All authors

6. Data analysis and interpretation: Asim Kichloo, Dushyant Singh Dahiya, Hafeez Shaka, Dhanshree Solanki

7. Final approval of manuscript: All authors

Declaration of interest

No potential conflict of interest was reported by the author(s).