CANNABIS USE DISORDER: FRIEND OR FOE IN SEPTIC SHOCK AND ASSOCIATED MORTALITY AMONG GERIATRIC SEPSIS PATIENTS WITH CHRONIC KIDNEY OR LIVER DISEASE?

TOPIC: Critical Care TYPE: Original Investigations PURPOSE: With the increasing medicinal use of cannabis and potential anti-inflammatory role, we aimed to assess odds in-hospital mortality septic shock with vs. without among geriatric sepsis patients chronic kidney or liver diseases (CKD/CLD) using a nationally representative cohort. METHODS: We queried National Inpatient Sample (2017) identify concomitant CKD/CLD complicated by shock. Primary outcomes (septic associated inpatient mortality) secondary (patient discharge length stay) were compared between users non-users. Multivariable analysis was performed adjusting for confounders mortality. A propensity score-matched confirm observed in unmatched cohorts. two-sided p-value<0.05 considered statistically significant. RESULTS: Of 675,850 admissions CKD/CLD, 146,915 (21.7%) experienced these, 90 users. Cannabis relatively younger (69 [66-73]), males (77.8% vs 53%) (p<0.001) Both cohorts had higher proportion white (>60%) often admitted non-electively (>88%). more frequently demonstrated alcohol abuse (22.2% 1.9%, p<0.001), coagulopathy (33.3% 22.5%, p=0.014), drug (38.9% 0.8%, pulmonary disease (44.4% 20.0%, showed lower frequency hypertension (72.2% 81.4%, p=0.025) diabetes mellitus (16.7% 32.2%, p=0.002) did not decrease risk on unadjusted (OR:0.90 95%CI:0.71-1.13, p=0.371) adjusted (demographics+hospital characteristics:OR:0.82 95%CI:0.65-1.04, p=0.100; plus comorbidities:OR:0.88 95%CI:0.69-1.13, p=0.325) regression but it significantly reduced septic-shock (OR:0.39 95%CI:0.22-0.67, p=0.001) characteristics:OR:0.25, 95%CI:0.13-0.49, p<0.001; comorbidities:OR:0.30 95%CI:0.15-0.59, p<0.001) multivariable analyses. Propensity-matched shock-cannabis (90) shock-nonusers (85) also confirmed 47.1%, p<0.001). discharged routinely (61.1% 48.5%, extended stay (8 7 days) hospital charges ($18,800 18,225$) non-users (p<0.05). CONCLUSIONS: affect developing even after confounders. Potential therapeutic application high-risk can be explored future prospective studies evaluate association mode, dose duration outcomes. CLINICAL IMPLICATIONS: The finding this study warrants explore role underlying which is encountered critical care settings. DISCLOSURES: No relevant relationships Ummul Asfeen, source=Web Response Harika Varma Chintalapalli Patta, Rupak Desai, Bushra Fatima, Zainab Gandhi, Praneeth Reddy Keesari, Taherunnisa Rida, Sashwath Srikanth, Nibras Yar Khan,