Problematic Cannabis Use and Risk of Complications in Patients with Chronic Hepatitis C

Abstract

Objectives To evaluate the risk of complication in hospitalized chronic hepatitis C (CHC), patients with cannabis use disorder (CUD). Methods We conducted a retrospective study using the nationwide inpatient sample (NIS), and included 31,623 patients (age 15-54) with a primary international classification of diseases, ninth revision (ICD-9) diagnosis for CHC and grouped by co-diagnosis of CUD (1101, 3.5%). Logistic regression model adjusted for confounders was used to evaluate the odds ratio (OR) of CUD and complications during CHC hospitalization. Results Comorbid CUD was prevalent in males (73.2%), Caucasians (59.9%), and from low-income families (65.7%). The most prevalent complications in patients with CUD were ascites (44.9%), alcoholic cirrhosis (42.8%) and non-alcoholic cirrhosis (41.1%). The odds of association for hepatic encephalopathy was 2.2 times higher (95% CI 1.477-3.350) in 2.8% CHC inpatients with CUD compared to 1.2% non-CUD inpatients. Hepatic encephalopathy had higher odds of association with a male by 1.4 times (95% CI 1.094-1.760), and African American by 1.7 times (95% CI 1.293-2.259). Conclusion CUD is significantly associated with 122% increased likelihood for hepatic encephalopathy that may worsen overall hospitalization outcomes in CHC patients. Hence, we need to consider the complex relationship between CUD and CHC and manage them optimally to improve the health-related quality of life.

Coagulopathy and Hospital Outcomes in Patients With Spontaneous Bacterial Peritonitis: A Call for Action to Improve Care of Inpatients

“…About one-third of patients with chronic hepatitis and liver diseases have alcohol use problems, including abuse and dependence [12]. CALD leads to decreased synthesis of clotting and inhibitor factors, decreased clearance of activated factors, quantitative and qualitative platelet defects, hyperfibrinolysis, and accelerated intravascular coagulation [13].…”

AASLD Practice Guidance: Palliative care and symptom‐based management in decompensated cirrhosis

“…[ 283 ] Some observational studies identified associations between cannabis and accelerated hepatic fibrosis, encephalopathy, and ascites in patients with chronic LD attributable to HCV and fatty liver disease. [ 284–287 ] However, other observational studies, including two meta‐analyses of marijuana use and HCV, did not find a significant association between cannabis and hepatic fibrosis. [ 288–291 ] Trials of medical cannabinoids/marijuana have generally excluded patients with cirrhosis, given their vulnerability to neuropsychiatric symptoms.…”

Chronic Alcoholic Liver Disease and Mortality Risk in Spontaneous Bacterial Peritonitis: Analysis of 6,530 Hospitalizations

“…About 10% to 20% of patients who are heavy drinkers develop alcohol-related liver diseases [8]. About 36% of patients with chronic hepatitis have alcohol dependence or abuse problems [9]. Hospital admission in alcoholic liver disease has increased by 18.3% [10] from 2012 to 2016.…”