TY - JOUR
T1 - Stroke in young cannabis users (18–49 years)
T2 - National trends in hospitalizations and outcomes
AU - Desai, Rupak
AU - Singh, Sandeep
AU - Patel, Krupa
AU - Goyal, Hemant
AU - Shah, Manan
AU - Mansuri, Zeeshan
AU - Patel, Smit
AU - Mahuwala, Zabeen K.
AU - Goldstein, Larry B.
AU - Qureshi, Adnan I.
N1 - Publisher Copyright:
© 2019 World Stroke Organization.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - 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.
AB - 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.
KW - Cannabis
KW - acute ischemic stroke
KW - legalization
KW - marijuana
KW - recreational use
KW - trends
KW - young-onset stroke
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U2 - 10.1177/1747493019895651
DO - 10.1177/1747493019895651
M3 - Article
C2 - 31870242
AN - SCOPUS:85087774047
SN - 1747-4930
VL - 15
SP - 535
EP - 539
JO - International Journal of Stroke
JF - International Journal of Stroke
IS - 5
ER -