Department of Internal Medicine, University of New Mexico School of Medicine, MSC10-5550, Albuquerque, NM 87131, USA.
Department of General Surgery, University of New Mexico School of Medicine, Albuquerque, NM, USA.
Curr Probl Cardiol. 2024 Jan;49(1 Pt C):102184. doi: 10.1016/j.cpcardiol.2023.102184. Epub 2023 Oct 30.
Venous Thromboembolism (VTE) carries significant clinical implications, and with the rise in cannabis consumption, its potential influence on VTE outcomes warrants investigation. Using the National Inpatient Sample (NIS) database (2016-2019), we analyzed 2,217,184 hospitalized VTE patients. Among these, 1.8 % (38,810) reported cannabis use. We compared demographics, comorbidities, in-hospital outcomes, and quality metrics between cannabis users and non-users with VTE. Cannabis users were chiefly younger males (average age 45 in cannabis users vs. 62 in non-cannabis users) from lower-income brackets. Notably, 5.4 % discharged against medical advice. Although in-hospital mortality was initially lower for cannabis users (2.8 % vs. 5.1 %, OR 0.6, 95 % CI 0.69-0.94, p = 0.008), this difference became non-significant post-propensity-score matching (aOR 0.9, 95% CI 0.72-1.10, p = 0.3). Non-users faced higher in-hospital complications, a trend that persisted post-PSM. Among cannabis users, key mortality predictors were peripheral vascular disease, acute kidney injury, vasopressor use, cardiogenic shock, myocardial infarction, invasive ventilation, and surgical embolectomy. Cannabis users also had a shorter hospital stay (4.2 vs. 5.4 days) and slightly reduced costs ($27,472.95 vs. $31,660.75). The significantly younger age of VTE patients who use cannabis, coupled with the considerable proportion discharging against medical advice, underscores the urgency for tailored care interventions. Additional research is vital to comprehensively understand the interplay between cannabis consumption and VTE outcomes.
静脉血栓栓塞症(VTE)具有重要的临床意义,随着大麻消费的增加,其对 VTE 结局的潜在影响值得研究。我们使用国家住院患者样本(NIS)数据库(2016-2019 年)分析了 2217184 例住院 VTE 患者。其中,1.8%(38810 例)报告有大麻使用史。我们比较了 VTE 患者中使用大麻和不使用大麻患者的人口统计学、合并症、住院结局和质量指标。大麻使用者主要是年龄较小的男性(大麻使用者的平均年龄为 45 岁,而非大麻使用者为 62 岁),且来自收入较低的阶层。值得注意的是,有 5.4%的患者未经医嘱就出院。尽管大麻使用者的住院死亡率最初较低(2.8%比 5.1%,OR 0.6,95%CI 0.69-0.94,p=0.008),但在倾向评分匹配后,这种差异变得无统计学意义(aOR 0.9,95%CI 0.72-1.10,p=0.3)。非使用者面临更高的院内并发症,这一趋势在倾向评分匹配后仍然存在。在大麻使用者中,主要的死亡预测因素是外周血管疾病、急性肾损伤、血管加压药的使用、心源性休克、心肌梗死、有创通气和手术取栓。大麻使用者的住院时间也较短(4.2 天比 5.4 天),费用略低(27472.95 美元比 31660.75 美元)。使用大麻的 VTE 患者明显更年轻,而且有相当大比例的患者未经医嘱就出院,这突显了制定有针对性的护理干预措施的紧迫性。需要进一步的研究来全面了解大麻消费与 VTE 结局之间的相互作用。