Rim Daniel, Kaye Alexander, Ranpura Akash, Verma Siddharth
Internal Medicine, Rutgers University, Newark, USA.
Gastroenterology and Hepatology, Veterans Affairs Medical Center, East Orange, USA.
Cureus. 2021 Jul 30;13(7):e16768. doi: 10.7759/cureus.16768. eCollection 2021 Jul.
Objectives Diverticulitis is a common cause of hospitalization. The use of substances such as tobacco and alcohol can predispose patients to diverticulitis, and smoking is also associated with an increased risk of diverticulitis complications. Cannabis availability is growing in the United States, but there is a lack of data on the effects of cannabis use on the outcomes of diverticulitis. Thus, we investigated the effects of cannabis use on diverticulitis outcomes. Methods A retrospective analysis was conducted using 2014 data from the National Inpatient Sample. Patient demographics and outcomes of diverticulitis were compared between the groups with and without a history of cannabis use. The outcomes of interest were inpatient mortality, length of stay, total hospital charge, intestinal obstruction, shock/hypotension, colectomy, intestinal abscess, intestinal fistula, and intestinal perforation. Results Among 48,214 patients with diverticulitis, 447 patients had a history of cannabis use. Patients with a history of cannabis use were younger, more likely to be male, less likely to be White, had a lower Charlson Comorbidity Index, and had shorter hospital stays. There were no significant differences in inpatient mortality and total hospital charge. After adjusting for age, sex, race, and the Charlson Comorbidity Index, cannabis use was an independent risk factor for intestinal obstruction in patients hospitalized with diverticulitis. There were no statistically significant differences in other outcomes. Conclusions This study indicates that patients hospitalized with diverticulitis with a history of cannabis use are more likely to have an intestinal obstruction. Inhibition of gastrointestinal motility by cannabis in the setting of diverticular inflammation may explain this finding.
目的 憩室炎是住院治疗的常见病因。烟草和酒精等物质的使用会使患者易患憩室炎，吸烟还与憩室炎并发症风险增加有关。在美国，大麻的可获得性在增加，但缺乏关于使用大麻对憩室炎结局影响的数据。因此，我们研究了使用大麻对憩室炎结局的影响。方法 使用来自全国住院患者样本的2014年数据进行回顾性分析。比较有和没有大麻使用史的两组患者的人口统计学特征和憩室炎结局。感兴趣的结局包括住院死亡率、住院时间、总住院费用、肠梗阻、休克/低血压、结肠切除术、肠脓肿、肠瘘和肠穿孔。结果 在48214例憩室炎患者中，447例有大麻使用史。有大麻使用史的患者更年轻，男性比例更高，白人比例更低，Charlson合并症指数更低，住院时间更短。住院死亡率和总住院费用无显著差异。在调整年龄、性别、种族和Charlson合并症指数后，使用大麻是憩室炎住院患者发生肠梗阻的独立危险因素。其他结局无统计学显著差异。结论 本研究表明，有大麻使用史的憩室炎住院患者更易发生肠梗阻。大麻在憩室炎症情况下对胃肠蠕动的抑制作用可能解释了这一发现。
