Abstract Details

Title Disparities in Treatment and Discharge Outcomes Among Cannabis Users in Ischemic Stroke Hospitalizations

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-009

Objective To assess the treatment disparities and their impact on discharge outcomes among cannabis users experiencing ischemic stroke hospitalizations.

Background Stroke is becoming more common in young adults and is the eighth leading cause of death in people aged 25 to 45 in the United States. Drug use is one of the most common modifiable risk factors for stroke in this age group. Although tobacco use and cocaine use are known risk factors for ischemic stroke, the role of cannabis use and its effect on stroke outcome is unknown. We hypothesized that ischemic stroke hospitalizations among cannabis users would be associated with intensive treatment and poor discharge outcomes.

Design/Methods We performed a population-based retrospective analysis of the Nationwide Inpatient Sample (years 2000-2017) in acute ischemic stroke adult hospitalizations to compare the treatment utilization and outcomes in cannabis users (dependent and non-dependent abuse) using ICD-9 and 10-CM codes. We evaluated discharge disposition as home vs non-home (transfer to a short-term hospital stay, skilled nursing facility(SNF), and home health care(HHC)). Weighted analyses using a chi-square test and multivariable survey logistic regression were used to evaluate the discharge outcomes.

Results

Amongst the total of 5,690,773 AIS hospitalizations, 50,895 (0.89%) cannabis users were identified from 2003 to 2017. Compared to non-cannabis, cannabis users had higher rate of mechanical thrombectomy and recombinant tissue plasminogen activator utilization (0.61% vs 0.27%) and (3.79% vs 2.81%), [p<0.0001], respectively. Study revealed that cannabis users had higher odds of transfer to a short-term hospital stay, SNF, and HHC after mechanical thrombectomy (OR 2.25, 95%CI 1.41-3.58) and rt-PA utilization (OR 1.29, 95%CI 1.09-1.53), [p<0.0001].

Conclusions Our findings indicate poor discharge outcomes among cannabis users in ischemic stroke hospitalizations, necessitating robust post-stroke treatment. Safety concerns regarding cannabinoid use in neurovascular insults warrant further longitudinal studies to delineate risks and benefits in stroke patients.

Authors/Disclosures
Neel Patel, MBBS PRESENTER	Dr. Patel has nothing to disclose.
Urvish K. Patel (Icahn School of Medicine At Mount Sinai/ Creighton University)	Mr. Patel has nothing to disclose.
San Kim, MD (Korea house)	Dr. Kim has nothing to disclose.
Aakriti Dhiman	No disclosure on file
Sanjana Prakash	No disclosure on file
Vipul Rakhunde	No disclosure on file
Mahesh Babu Tatineni	No disclosure on file
JYOTHSNA GORANTI	No disclosure on file
Lokesh Patil (Stony Brook Medicine)	No disclosure on file
Greshaben Patel	Ms. Patel has nothing to disclose.
Prasannakumar K. Gajera, MBBS	Dr. Gajera has nothing to disclose.
Ravi Soni, MD, MBBS	Dr. Soni has nothing to disclose.
Nils Nilo (Mount Sinai)	No disclosure on file
Shamik Shah, MBBS (Stormont Vail Health, NeuroHospitalist Program)	Dr. Shah has nothing to disclose.

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