Stroke in young cannabis users (18–49 years): National trends in hospitalizations and outcomes

Rupak Desai, Sandeep Singh, Krupa Patel, Hemant Goyal, Manan Shah, Zeeshan Mansuri, Smit Patel, Zabeen K. Mahuwala, Larry B. Goldstein, Adnan I. Qureshi

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background: Recent legalization of therapeutic and recreational cannabis use makes it imperative to have an insight into odds and trends in young-onset stroke-related hospitalizations among cannabis users (18–49 years). 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.

Original languageEnglish
Pages (from-to)535-539
Number of pages5
JournalInternational Journal of Stroke
Issue number5
StatePublished - Jul 1 2020

Bibliographical note

Publisher Copyright:
© 2019 World Stroke Organization.


  • Cannabis
  • acute ischemic stroke
  • legalization
  • marijuana
  • recreational use
  • trends
  • young-onset stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology


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