Assessing the Relationship Between Cannabis Use and DKA Outcomes: Insights from a National Inpatient Sample Study

Abstract

ABSTRACTDKA hospitalizations in the United States have risen across all age groups, with the highest rates observed in individuals under 45 years of age. While the ongoing decline in in-hospital DKA mortality is encouraging, further efforts are needed to identify at-risk populations. Cannabis is one of the most used recreational drugs in the world, and studies have shown that it may be related to an increased risk of DKA. While prior data assessed it impact on incidence on DKA, there exists a knowledge gap about its impact on in-patient outcomes of DKA. We designed a study aimed to investigate the impact of cannabis use on DKA outcomes using the National Inpatient Sample (NIS) dataset. Our study is a retrospective observational study, in which, we identified patient with DKA and divided them into two cohorts: those who use cannabis and those who don’t. After matching both the groups for age groups, medical conditions (e.g., AIDS, COPD, heart failure, hypertension, liver disease, malignancy), gender, obesity, smoking status, and race/ethnicity, the two groups were compared for the primary outcome of inpatient mortality and secondary outcomes including shock, acute kidney injury, acute coronary syndrome, ischemic stroke, acute respiratory failure, invasive mechanical ventilation, cardiac arrest. Contrary to prior studies showing increased overall mortality risk associated with cannabis use, out study does not show worse DKA outcomes in cannabis users. In fact, cannabis is associated with a statistically significant decrease in the odds of mortality in the matched cohort. While no conclusion regarding causative or protective effects could be drawn from this study, it helps explore unique demographic and clinical characteristics of populations, to identify at-risk populations for various outcomes of in-patient DKA admissions.