Department of Pediatrics, Division of Pediatric Cardiology, Rush University Medical Center, Chicago, IL 60612, USA.
Department of Pediatrics, University Hospitals Rainbow Babies and Children's Hospital, Cleveland, OH 44106, USA.
Europace. 2021 Aug 6;23(8):1302-1309. doi: 10.1093/europace/euab033.
Cannabis is an increasingly common recreational substance used by teenagers. However, there is limited data probing association of cardiac arrhythmias with marijuana use in this population.
We provide prevalence trends, disease burden and healthcare utilization of cardiac arrhythmias associated with cannabis use disorder (CUD) in hospitalized teenagers (13-20 years) using a large national administrative database in the United States from 2003-2016. We used partial least square regression analysis for assessing trends in prevalence of cardiac arrhythmias and multiple logistic regression to elucidate independent predictors of arrhythmias associated with CUD. Among all CUD related hospitalizations (n = 876, 431), 0.5% had arrhythmias. Prevalence trends of arrhythmias among CUD increased six-fold during the study period (P < 0.001). CUD was more prevalent in males and older teens (both P < 0.001). There was a significant risk for mortality when CUD was associated with arrhythmia (7.4% vs. 0.1%, P < 0.001). While mean length-of-stay (LOS) was shorter (4.4 vs. 5.4 days, P < 0.001) for patients with CUD, they incurred three times higher mean hospitalization charges when compared to CUD patients without arrhythmia ($45 959 vs. $18 986, P < 0.001). Both LOS and hospitalization charges showed an uptrend during the study period (P < 0.001). Congenital heart disease, congestive heart failure, hypertension, and obesity independently predicted arrhythmias in CUD while other substance abuse did not change the risk of arrhythmia in CUD.
Arrhythmia burden is increasing among teenagers with CUD, and co-occurrence of arrhythmia and CUD worsens hospital outcomes.
大麻是青少年中越来越常见的消遣性物质。然而，在这一人群中，关于大麻使用与心律失常之间关联的研究数据有限。
我们利用美国一个大型国家行政数据库，提供了 2003 年至 2016 年期间患有大麻使用障碍（CUD）的住院青少年（13-20 岁）中心律失常的流行趋势、疾病负担和医疗保健利用情况。我们使用偏最小二乘回归分析评估心律失常的流行趋势，并使用多因素逻辑回归分析阐明与 CUD 相关的心律失常的独立预测因素。在所有与 CUD 相关的住院治疗中（n=876，431），有 0.5%的患者患有心律失常。在研究期间，CUD 相关心律失常的患病率趋势增加了六倍（P<0.001）。CUD 在男性和年龄较大的青少年中更为常见（均 P<0.001）。当 CUD 与心律失常相关时，死亡率显著升高（7.4%比 0.1%，P<0.001）。尽管患有 CUD 的患者平均住院时间（LOS）较短（4.4 天比 5.4 天，P<0.001），但与没有心律失常的 CUD 患者相比，他们的平均住院费用高出三倍（45959 美元比 18986 美元，P<0.001）。在研究期间，LOS 和住院费用均呈上升趋势（P<0.001）。先天性心脏病、充血性心力衰竭、高血压和肥胖症独立预测了 CUD 中的心律失常，而其他物质滥用并没有改变 CUD 中发生心律失常的风险。
患有 CUD 的青少年中心律失常负担正在增加，心律失常与 CUD 同时发生会使住院治疗结果恶化。
