Methods
The
National Inpatient Sample dataset (2007–2014) was utilized to assess
national trends, odds of young-onset stroke-related hospitalizations,
and outcomes among cannabis users vs. nonusers using provided discharge
weights, strata, and cluster design. The rates are described per 100,000
hospitalizations among cannabis users and non-users.
Results
A
total of 3,307,310 hospitalizations were identified among young adults
with
current or previous cannabis use. Of these, 34,857 (1.1%) were
related to young-onset stroke. A relative increase of 13.92% (553 in
2007 to 630 in 2014;
ptrend < 0.001) in young-onset
stroke admissions was reported among cannabis users. The odds of any
stroke (OR 1.16, 95% CI 1.14–1.19,
p < 0.001) and acute ischemic stroke (OR 1.41, 95% CI 1.31–1.51,
p < 0.001)
hospitalizations were considerably higher among cannabis users as
compared to nonusers. In-hospital mortality rates were increasing (3.7%
to 4.3%) among cannabis users whereas decreasing (7.7% to 5.9%) in
nonusers from 2007 to 2014 (
ptrend < 0.001). The
mean length of stay and the hospitalization charges showed increasing
trends in cannabis-related young-onset stroke admissions. There was an
increasing trend in young-onset stroke admissions among male cannabis
users (578 to 701;
ptrend < 0.001) but not among females (516 to 457;
ptrend = 0.14). The maximum rise in the young-onset stroke-related admissions was seen in African Americans (743 to 996;
ptrend < 0.001).
Conclusions
We
identified rising trends and higher risk (16% higher of overall
young-onset stroke, 41% higher of acute ischemic stroke) of
stroke-related hospitalizations and worse outcomes among cannabis users
aged 18–49 years from 2007 to 2014.
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