Abstract 4145081: ACUTE ISCHEMIC STROKE IN YOUNG CANNABIS USERS: A NATIONWIDE ANALYSIS

Background: The incidence of stroke in young adults is on the rise in the United States. Drug abuse has been proposed as a known modifiable risk factor for stroke in this age group. The association between cannabis use and stroke in young adults is an area that needs further exploration. Research Hypothesis: Cannabis is an independent modifiable risk factor for stroke in young adults with Cannabis Use Disorder(CUD). Aim: To investigate the association between Cannabis Use Disorder(CUD) and Stroke in young adults. Methods: Using the National Inpatient Sample 2019, admissions for stroke in the age group of 18-45 were identified. The cohort was subdivided into admissions with documented CUD. Demographic data of the cohort was analyzed, including the prevalence of comorbid conditions. Using multivariate binomial logistic regression, the association between cannabis use and the occurrence of stroke was studied, after accounting for age, smoking, cocaine abuse, and uncontrolled hypertension(HTN). A two-tailed p-value <0.05 was used to determine statistical significance. Results: Out of the 13,514 stroke admissions identified, 1,027 (7.06%) had documented CUD. Analyzing the population, 63.87% were male, 39.57% were White, 38.5% were Black, and 12.3% were Hispanic. The prevalence of other comorbid conditions in this group included uncontrolled HTN (45.67%), alcohol abuse (15.78%), major depression (13.08%), COPD (11.56%), congestive heart failure (8.95%), and cocaine abuse (5.98%). [Table 1] The crude odds ratio (OR) for stroke among admissions with CUD was 2.998 (95% CI: 2.587-3.473, p=0.000). Significant association with stroke was also found between documented cocaine abuse (OR: 1.604, 95%CI: 1.195-2.152), smoking (OR: 2.214, 95%CI: 1.374-3.569), and uncontrolled HTN (OR: 2.114, 95%CI: 1.959-2.281,). Using binomial logistic regression analysis, after adjusting for age, smoking, cocaine abuse, and uncontrolled hypertension, the association between stroke and cannabis use disorder remained significant: OR of 2.956 (95%CI: 2.541-3.440). [Table 2] Further analyzing 543,445 admissions of individuals aged 18-45 with documented CUD, we identified the following as significant risk factors for the occurrence of stroke: Black race (OR: 1.556, 95%CI: 1.16-2.08), uncontrolled hypertension (OR: 5.222, 95%CI: 3.92-6.94), congestive heart failure (OR: 2.763, 95%CI: 1.67-4.55), and a history of myocardial infarction (OR: 2.346, 95%CI: 1.15-4.76). [Table 3]