The following article is a part of conference coverage from CHEST 2021, being held virtually from October 17 to October 20, 2021. The team at Pulmonology Advisor will be reporting on the latest news and research conducted by leading experts in the field. Check back for more from CHEST 2021.
Among patients hospitalized due to asthma, those who use cannabis are more likely to receive ventilation. Moreover, this patient population is more likely to include patients who are young, male, Black, and of lower socio-economic status. These were among the findings included in a poster presentation for the CHEST Annual Meeting, held virtually October 17 to 20.
Cannabis use is on the rise. Because it is primarily inhaled as smoke, it acts as an instigator for respiratory symptoms, especially in patients with asthma. To address the lack of population-based studies estimating the burden and outcomes of asthma hospitalizations for individuals who use cannabis, researchers conducted a study to estimate the trends and characteristics associated with cannabis use among patients with asthma.
The study cohort was derived from 1,014,328 young adult patients hospitalized for asthma between 2008 and 2017 in the Nationwide Inpatient Sample. Of these, 36,008 patients (3.6%) had concurrent cannabis use disorder. The investigators found that the proportion of patients using cannabis increased from 1.8% in 2007 to 7.5% in 2018, with a yearly increase of 14.9%. They also noted that patients with concurrent cannabis use were younger and more likely to be male and Black.
Through multivariable regression analysis of the study cohort, researchers assessed the association between cannabis use and the following factors:
- age group 18-34 years (odds ratio [OR] 1.9; 95% CI, 1.5-2.0; P <.01)
- women (OR 2.1; 95% CI, 2.0-2.3; P <.01)
- Black individuals (OR 1.8; 95% CI, 1.6 -1.9, P <.01),
- lowest income status (OR 1.3; 95% CI, 1.2-1.4, P <.01)
- west region (OR 1.6; 95% CI, 1.4-1.7, P <.01),
- uninsured/self-pay (OR 1.1 ;95% CI, 1.1-1.2, P =.006)
- weight loss (OR 1.8; 95% CI, 1.4-2.2, P <.01)
- alcoholism (OR 3.8; 95% CI, 3.4-4.3, P <.01)
Notably, after adjusting with confounding factors, cannabis use was not associated with in-hospital mortality or discharge to facilities. Cannabis use was, however, associated with higher odds of noninvasive ventilation (OR 1.3; 95% CI, 1.2-1.5, P <.01) and invasive ventilation (OR 1.4; 95% CI, 1.6-1.7, P <.01).
The investigators concluded that their study, which showed 1) the characteristics of asthma patients using cannabis, 2) an increasing trend toward such usage, and 3) the association between cannabis use and ventilation, also pointed to the need for additional research and guidelines for addressing this patient population.
Shah H, Anuniru O, Patel N, et al. Increasing trend and poor outcomes associated with cannabis use in young asthmatics. Presented at: CHEST 2021; October 17-20, 2021; Orlando, FL/Virtual. Abstract A1905.