Pulmonary circulation disorders in cannabis users tripled over seven years with doubled mortality risk | Research

The takeaway

A nationwide analysis of 3.3 million cannabis-related hospitalizations found that pulmonary circulation disorder cases increased 200% from 2007 to 2014, with those patients facing twice the in-hospital mortality risk.

Pulmonologists, cardiologists, cannabis users concerned about cardiovascular health, and healthcare system planners.

200% increase in PCD; 2.17x adjusted mortality risk

What the researchers found

Among 3,307,310 cannabis-related hospitalizations, 20,328 (0.61%) involved pulmonary circulation disorders. PCD-related hospitalizations increased 200% (from 0.3% to 0.9%) over the study period. Patients with cannabis and PCD had an all-cause in-hospital mortality of 4.1% vs. 0.5% without PCD. Adjusted odds ratio for mortality was 2.17.

Why it matters

The 200% increase in pulmonary circulation disorders among cannabis users, combined with doubled mortality risk, suggests this is an emerging and potentially life-threatening complication that clinicians should monitor.

The numbers in context

3,307,310 total cannabis hospitalizations. 20,328 with PCD (0.61%). 200% relative increase in PCD prevalence (0.3% to 0.9%, 2007-2014). In-hospital mortality: 4.1% with PCD vs. 0.5% without. Adjusted OR for mortality: 2.17 (95% CI: 1.99-2.36). PCD patients were older (mean 47 vs. 34 years). Median hospital stay: 6 vs. 3 days.

How the study worked

Analysis of the National Inpatient Sample (NIS) from 2007-2014, comparing cannabis users with pulmonary circulation disorders to those without. Examined demographics, comorbidities, and in-hospital outcomes including mortality and healthcare utilization.

What this study cannot tell us

Administrative database study cannot establish causation. ICD coding may misclassify conditions. Cannabis use disorder diagnosis does not capture dose, duration, or route. PCD patients were older with more comorbidities, which confound the mortality comparison. Temporal association does not prove cannabis caused PCD.

How to read the evidence

Large nationwide database study with 3.3 million hospitalizations and multivariable adjustment, though limited by administrative data constraints.

When this study was published

Published in 2022, covering 2007-2014 NIS data.

The bigger picture

While cardiovascular effects of cannabis have received less attention than respiratory or psychiatric risks, this study suggests pulmonary vascular disease may be an underrecognized complication of cannabis use disorder.

Questions still open

Is smoking route responsible, or do all cannabis delivery methods carry pulmonary vascular risk? Would the trend continue after 2014 with rising cannabis use?

Common questions

Can cannabis cause lung circulation problems?

This nationwide study found a 200% increase in pulmonary circulation disorders among cannabis users from 2007 to 2014, with those patients having twice the in-hospital mortality risk, though causation was not established.

How dangerous are pulmonary complications from cannabis?

Cannabis users with pulmonary circulation disorders had 4.1% in-hospital mortality versus 0.5% for those without, stayed twice as long in the hospital, and were more likely to need skilled nursing care after discharge.

Read the original research

Nationwide Trends in Hospitalizations and Outcomes of Pulmonary Circulation Disorders Among Patients With Cannabis Use Disorder in the United States.

Cureus, 14(3), e22897

View on PubMed ↗Publisher’s paper ↗

Citation

Jain, Akhil; Gandhi, Zainab; Desai, Rupak; Mansuri, Uvesh; Rizvi, Bisharah; Alvarez, Melissa; Gupta, Puneet. (2022). Nationwide Trends in Hospitalizations and Outcomes of Pulmonary Circulation Disorders Among Patients With Cannabis Use Disorder in the United States.. Cureus, 14(3), e22897. https://doi.org/10.7759/cureus.22897