Young adults with cannabis use disorder had lower odds of pulmonary embolism hospitalization but longer hospital stays when admitted | Research

The takeaway

In a national database of over 8 million young adult hospital admissions, cannabis use disorder was associated with lower odds of pulmonary embolism but longer stays and higher costs when PE did occur.

Emergency medicine and internal medicine physicians treating young adults; researchers studying cannabis and cardiovascular risk.

8.4 million admissions; 20% lower PE odds with CUD

What the researchers found

Among 8,438,858 young adult (18-44) admissions in 2018, 61,965 were PE-related, with 1,705 (0.6%) having cannabis use disorder. After adjustment, CUD was associated with lower odds of PE hospitalization (OR 0.80, 95% CI 0.71-0.90). In-hospital mortality did not differ between groups. However, the CUD group had longer median hospital stays and higher costs.

Why it matters

The relationship between cannabis use and blood clot risk is poorly understood. This large national analysis provides unexpected findings that challenge assumptions about cannabis and thromboembolism in younger patients.

The numbers in context

8,438,858 young adult admissions. 61,965 PE-related (0.7%). CUD prevalence among PE admissions: 0.6%. Adjusted OR for PE with CUD: 0.80 (95% CI 0.71-0.90). No mortality difference. Longer hospital stays and higher costs in the CUD group.

How the study worked

Retrospective analysis of the 2018 National Inpatient Sample. Multivariable regression adjusted for covariates. Propensity score-matched analysis (1:6) was also performed to assess in-hospital outcomes.

What this study cannot tell us

Cross-sectional database analysis cannot determine causation. CUD diagnosis codes undercount cannabis use. Cannot distinguish dose, frequency, or method of use. Administrative data may have coding inaccuracies. Single-year analysis.

How to read the evidence

Large national database with propensity matching, but cross-sectional design and administrative data limit causal inference.

When this study was published

2024 study

The bigger picture

The lower odds of PE hospitalization in cannabis users is counterintuitive given reports of prothrombotic effects. This may reflect confounding by age, other substance use patterns, or differences in how cannabis users present to hospitals rather than a true protective effect.

Questions still open

What explains the paradoxically lower PE odds? Is the longer hospital stay related to substance use management rather than PE severity?

Common questions

What is a pulmonary embolism?

A blood clot that travels to the lungs, blocking blood flow. It can be life-threatening and typically causes sudden shortness of breath, chest pain, and rapid heart rate.

Does this mean cannabis protects against blood clots?

Not necessarily. The lower odds could reflect confounding factors like age differences, other health behaviors, or how cannabis users access healthcare rather than a biological protective effect.

Read the original research

Association of Cannabis Use Disorder With Hospitalizations for Pulmonary Embolism and Subsequent in-Hospital Mortality in Young Adults: A Contemporary Nationwide Analysis.

Journal of the American Heart Association, 13(13), e032787

View on PubMed ↗Publisher’s paper ↗

Citation

Desai, Rupak; Ghadge, Nitin; Kanagala, Sai Gautham; Katukuri, Nishanth; James, Alpha; Kadiyala, Avinash; Vutukuru, Sai Diksha; Kotharu, Meghana; Borzoo, Tajdin; Nalla, Akhila; Vyas, Ankit; Priyadarshni, Shivani; Shalaby, Mostafa; Khalife, Wissam. (2024). Association of Cannabis Use Disorder With Hospitalizations for Pulmonary Embolism and Subsequent in-Hospital Mortality in Young Adults: A Contemporary Nationwide Analysis.. Journal of the American Heart Association, 13(13), e032787. https://doi.org/10.1161/JAHA.123.032787