Burden of Comorbidities in Hospitalizations for Cannabis Use-associated Intractable Vomiting during Post-legalization Period
Burden of Comorbidities in Hospitalizations for Cannabis Use-associated Intractable Vomiting during Post-legalization Period
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DOI：
10.7759/cureus.5502
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发表时间：
2019-08-27
影响因子：
1.2
通讯作者：
Goyal, Hemant
中科院分区：
文献类型：
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作者：
Madireddy, Sowmya;Patel, Rikinkumar S.;Goyal, Hemant
目的本研究的目的是观察难治性呕吐和大麻使用障碍（CUD）的人口统计学特征、医学和精神合并症以及住院结局的趋势。方法采用2010 - 2014年全国住院患者样本进行回顾性队列研究。年龄16-50岁的出院患者，主要诊断为难治性呕吐和CUD （N = 9601）。我们分别使用线性逐线性关联卡方检验和独立样本t检验来测量分类数据和连续数据。结果顽固性呕吐合并CUD的住院次数呈上升趋势（P < 0.001）， 5年内增加28.6%。大约一半的研究人群包括年轻（16-30岁，48.4%）男性（57.2%）。难治性呕吐合并CUD的患病率在非西班牙裔白人和黑人中呈下降趋势（P = 0.041），而在西班牙裔中上升了778%。平均住院时间为3.2天，呈线性下降趋势，住院总费用呈上升趋势（P < 0.001），平均为22,890美元。电解质紊乱（55.3%）、高血压（25.3%）、慢性肺部疾病（11.9%）、缺乏性贫血（10.3%）是主要合并症，其中贫血呈显著上升趋势（P = 0.004）。焦虑症在5年内从20.8%增加到30.8%，而抑郁症从19.2%下降到16.4% （P < 0.001）。41.2%的CUD患者同时存在烟草滥用/依赖。结论我们的研究结果显示，在过去的五年中，与CUD相关的难治性呕吐住院人数明显增加。应该让公众和保健从业人员意识到大麻对胃肠道的矛盾副作用。
ObjectiveThe aim of this study was to observe the trends of intractable vomiting and cannabis use disorder (CUD) with demographic characteristics, medical and psychiatric comorbidities, and hospitalization outcomes.MethodsWe conducted a retrospective cohort study using the nationwide inpatient sample (2010 to 2014). Patients aged 16-50 years discharged with a primary diagnosis of intractable vomiting and CUD were included (N = 9,601). We used the linear-by-linear association chi-square test and independent-sample T-test for measuring the categorical and continuous data, respectively.ResultsThe number of intractable vomiting hospitalizations with CUD had an increasing trend (P < 0.001) with a 28.6% increase over five years. About half of the study population included young (16-30 years, 48.4%) males (57.2%). There was a decreasing trend (P = 0.041) in the prevalence of intractable vomiting with CUD in non-Hispanic Whites and Blacks, whereas there was 778% increase in Hispanics. The mean length of stay was 3.2 days which had a decreasing linear trend, and total hospital charges showed an increasing trend (P < 0.001), averaging $22,890. Electrolyte disorders (55.3%), hypertension (25.3%), chronic lung disease (11.9%), and deficiency anemia (10.3%) constituted the majority of comorbidities, with anemia showing a statistically significant increasing trend (P = 0.004). Anxiety disorders increased from 20.8% to 30.8% over five years, whereas depression decreased from 19.2% to 16.4% (P < 0.001). Concomitant tobacco abuse/dependence was present in 41.2% of patients with CUD.ConclusionThe results of our study show that the intractable vomiting hospitalizations related to CUD have increased significantly over a five-year period. The general public and healthcare practitioners should be made aware of the paradoxical gastrointestinal side effects of cannabis.