Division of Pulmonary Diseases and Critical Care Medicine, Yale-New Haven Health Bridgeport Hospital, Bridgeport, Connecticut, USA.
Division of Cardiovascular Medicine, The University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.
Cannabis Cannabinoid Res. 2021 Aug;6(4):340-348. doi: 10.1089/can.2020.0133. Epub 2021 Feb 15.
Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of mortality in the United States. Due to the ongoing legalization of cannabis, its acceptance, availability, and use in the in-patient population are on the rise. In this retrospective study, we investigated the association of cannabis use with important outcomes in COPD hospitalizations. The National Inpatient Sample (NIS) data were analyzed from 2005 to 2014. The primary outcome of interest was the trends and outcomes of cannabis use among COPD hospitalizations, including in-hospital mortality, pneumonia, sepsis, and respiratory failure. We identified 6,073,862 hospitalizations, 18 years of age or older, with COPD using hospital discharge codes. Of these, 6,049,316 (99.6%) were without cannabis use, and 24,546 (0.4%) were admitted with cannabis use. The majority of COPD hospitalizations with cannabis use were aged 50-64 (60%). Cannabis use was associated with lower odds of in-hospital mortality (odds ratio [OR] 0.624 [95% confidence interval (CI) 0.407-0.958]; =0.0309) and pneumonia (OR 0.882 [95% CI 0.806-0.964]; =0.0059) among COPD hospitalizations. Cannabis use also had lower odds of sepsis (OR 0.749 [95% CI 0.523-1.071]; =0.1127) and acute respiratory failure (OR 0.995 [95% CI 0.877-1.13]; =0.9411), but it was not statistically significant. Among hospitalized patients with a diagnosis of COPD, cannabis users had statistically significant lower odds of in-hospital mortality and pneumonia compared to noncannabis users. The association between cannabis use and these favorable outcomes deserves further study to understand the interaction between cannabis use and COPD.
慢性阻塞性肺疾病（COPD）是美国第四大死亡原因。由于大麻的持续合法化，其在住院患者中的接受度、可获得性和使用率都在上升。在这项回顾性研究中，我们调查了大麻使用与 COPD 住院重要结局的关系。 国家住院患者样本（NIS）数据从 2005 年至 2014 年进行分析。主要研究结果是 COPD 住院患者中大麻使用的趋势和结果，包括院内死亡率、肺炎、败血症和呼吸衰竭。 我们确定了 6073862 例年龄在 18 岁或以上的 COPD 住院患者，使用医院出院代码。其中，6049316 例（99.6%）没有大麻使用史，24546 例（0.4%）因大麻使用而入院。有大麻使用史的 COPD 住院患者中，年龄在 50-64 岁的占大多数（60%）。与 COPD 住院患者的院内死亡率（比值比 [OR] 0.624 [95%置信区间 0.407-0.958]；=0.0309）和肺炎（OR 0.882 [95%置信区间 0.806-0.964]；=0.0059）呈负相关。大麻使用与败血症（OR 0.749 [95%置信区间 0.523-1.071]；=0.1127）和急性呼吸衰竭（OR 0.995 [95%置信区间 0.877-1.13]；=0.9411）的发生几率降低也呈负相关，但无统计学意义。 在诊断为 COPD 的住院患者中，与非大麻使用者相比，大麻使用者的院内死亡率和肺炎发生率显著降低。大麻使用与这些有利结果之间的关系值得进一步研究，以了解大麻使用与 COPD 之间的相互作用。
