title: Marijuana use and inpatient outcomes among hospitalized patients: analysis of the nationwide inpatient sample database.
abstract: The purpose of this paper is to examine the relationship between marijuana use and health outcomes among hospitalized patients, including those hospitalized with a diagnosis of cancer. A total of 387,608 current marijuana users were identified based on ICD-9 codes for marijuana use among hospitalized patients in the Nationwide Inpatient Sample database between 2007 and 2011. Logistic regression analysis was performed to determine the association between marijuana use and heart failure, cardiac disease, stroke, and in-hospital mortality. All models were adjusted for age, gender, race, residential income, insurance, residential region, pain, and number of comorbidities. Among hospitalized patients, marijuana use was associated with a 60% increased odds of stroke (OR: 1.60, 95% CI: 1.44-1.77) compared with non-users, but significantly reduced odds of heart failure (OR: 0.78, 95% CI: 0.75-0.82), cardiac disease (OR: 0.86, 95% CI: 0.82-0.91), or in-hospital mortality (OR: 0.41, 95% CI: 0.38-0.44). Among cancer patients, odds of in-hospital mortality was significantly reduced among marijuana users compared with non-users (OR: 0.44, 95% CI: 0.35-0.55). Hospitalized marijuana users were more likely to experience a stroke compared with non-users, but less likely to experience in-hospital mortality. Prospective studies will be needed to better characterize the health effects of marijuana use, especially among older, sicker, and/or hospitalized patients. In the meantime, conversations regarding marijuana use/misuse may be warranted in the clinical setting in order for patients and healthcare providers to adequately weigh the anticipated benefits of marijuana use with potentially significant health risks.
authors.affiliation: University of Northern Colorado Cancer Rehabilitation Institute, Greeley, Colorado.|School of Social Work, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado.
authors.forename: Neomi
authors.initials: N
authors.lastname: Vin-Raviv
authors.affiliation: Department of Epidemiology, University of Alabama School of Public Health, Birmingham, Alabama.|Comprehensive Cancer Center, University of Alabama School of Public Health, Birmingham, Alabama.
authors.forename: Tomi
authors.initials: T
authors.lastname: Akinyemiju
authors.affiliation: Department of Biostatistics, University of Alabama School of Public Health, Birmingham, Alabama.
authors.forename: Qingrui
authors.initials: Q
authors.lastname: Meng
authors.affiliation: Department of Epidemiology, University of Alabama School of Public Health, Birmingham, Alabama.
authors.forename: Swati
authors.initials: S
authors.lastname: Sakhuja
authors.affiliation: University of Northern Colorado Cancer Rehabilitation Institute, Greeley, Colorado.|School of Sport and Exercise Science, University of Northern Colorado, Greeley, Colorado.
authors.forename: Reid
authors.initials: R
authors.lastname: Hayward
mesh_terms: D059019:Clinical Coding; D005260:Female; D006333:Heart Failure / Q000453:epidemiology* / Q000209:etiology; D017052:Hospital Mortality; D006760:Hospitalization; D006801:Humans; D007297:Inpatients; D008297:Male; D008385:Marijuana Smoking / Q000009:adverse effects / Q000453:epidemiology*; D009369:Neoplasms; D011446:Prospective Studies; D012042:Registries; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology
keywords: Cancer patients; hospitalized patients; inpatient outcomes; marijuana use