Gubatan John, Staller Kyle, Barshop Kenneth, Kuo Braden
Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Dig Dis Sci. 2016 Jul;61(7):1844-52. doi: 10.1007/s10620-016-4090-9. Epub 2016 Mar 2.
The role of cannabinoids in gastrointestinal diseases is controversial and of great interest, yet their use in patients has not been critically examined.
To determine the prevalence and effects of cannabis abuse on healthcare utilization, as measured by emergency department (ED) visits, in a large, tertiary gastroenterology practice.
All patients seen in the gastroenterology clinic at a tertiary care center during a 27-year period (1986-2013) were included in our study to determine the overall prevalence of cannabis abuse. We matched cannabis abusers 1:2 with non-abusing controls to determine the effect of cannabis on ED utilization, our primary outcome. We used multivariate linear regression to adjust for confounders and define the independent effect of cannabis abuse on ED utilization.
Our prevalence study cohort included 190,303 GI clinic patients with an overall cannabis abuse prevalence of 0.80 % (1520 patients). From 1986 to 2012, the prevalence of cannabis abuse in this clinic increased by 0.73 % (0.03 %/year) (p < 0.0001). From the 1520 cannabis abusers identified, 467 patients were randomly selected as cases and were matched to 934 controls. From this retrospective cohort, the median ED visits/year for cannabis abusers was 1.88 versus 0.89 for non-abusers (p < 0.0001). After multivariate adjustment, cannabis abuse was associated with a 1.47-fold increase (95 % CI 1.23-1.76, p < 0.0001) in median ED visits/year.
Reported cannabis abuse in GI clinic patients is less prevalent than in the adult US population, but is increasing. Cannabis abuse among gastroenterology patients is associated with increased ED visits.
大麻素在胃肠道疾病中的作用存在争议且备受关注，但尚未对其在患者中的使用进行严格审查。
在一家大型三级胃肠病学诊所中，确定大麻滥用在医疗保健利用方面的患病率和影响，以急诊就诊次数作为衡量指标。
纳入一家三级医疗中心胃肠病学诊所27年期间（1986 - 2013年）就诊的所有患者，以确定大麻滥用的总体患病率。我们将大麻滥用者与非滥用对照按1:2进行匹配，以确定大麻对急诊就诊利用的影响，这是我们的主要结局。我们使用多变量线性回归来调整混杂因素，并确定大麻滥用对急诊就诊利用的独立影响。
我们的患病率研究队列包括190303名胃肠病学诊所患者，大麻滥用的总体患病率为0.80%（1520名患者）。从1986年到2012年，该诊所大麻滥用的患病率增加了0.73%（每年0.03%）（p < 0.0001）。从确定的1520名大麻滥用者中，随机选择467名患者作为病例，并与934名对照进行匹配。在这个回顾性队列中，大麻滥用者每年急诊就诊的中位数为1.88次，而非滥用者为0.89次（p < 0.0001）。经过多变量调整后，大麻滥用与每年急诊就诊中位数增加1.47倍相关（95%置信区间1.23 - 1.76，p < 0.0001）。
胃肠病学诊所患者中报告的大麻滥用情况比美国成年人群体中少见，但呈上升趋势。胃肠病学患者中的大麻滥用与急诊就诊次数增加有关。
