S259 Cannabis Use Is Associated With Better Outcomes in Patients With Acute Pancreatitis: A Propensity-Matched Analysis

Introduction: The rate of cannabis use has been increasing especially since the legalization of marijuana in the United States and is estimated to be used by over 200 million people worldwide. There has been conflicting evidence regarding the effect of cannabis in acute pancreatitis (AP), with studies suggesting a potential protective effect of cannabis while others suggesting an increase in incidence of AP in cannabis users. This study aims to compare and highlight the demographics and outcomes in patient with AP who used cannabis compared to those who did not use cannabis. Methods: This retrospective cohort study used the TriNetX research network to identify adults (≥18 years) diagnosed with AP irrespective of the etiology. Patients were matched using propensity score matching and stratified to 2 groups: Patients who used cannabis and patients who did not. The primary outcome was the 30-day all-cause mortality. Secondary outcomes included 30-day incidence of intensive care unit (ICU) admission, acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), sepsis. Patients’ median follow-up was 1 year for both cohorts. Results: A total of 33,455 patients with AP who used cannabis were identified and propensity matched with 33,455 patients with AP who did not use cannabis. Among unmatched samples, cannabis users had increased rates of alcohol use, cholelithiasis, cigarette smoking, and cancers (all P < 0.001). Cannabis use in patients with AP was associated with decreased all-cause mortality (adjusted Odds Ratio (aOR) = 0.73, 95% CI: 0.65-0.82), ICU admissions (adjusted Odds Ratio (aOR) = 0.73, 95% CI: 0.65-0.82), ARDS (aOR = 0.63, 95% CI: 0.81-0.93), AKI (aOR = 0.94, 95% CI: 0.88-0.99), and sepsis (aOR 0.87, 95% CI: 0.80-0.95). Conclusion: This retrospective cohort study found that cannabis use could be protective in patients with acute pancreatitis, with decreased rates of all-cause mortality, ICU admission, ARDS, AKI, and sepsis. Additional prospective studies should be performed to assess the possible pathophysiological mechanisms explaining these differences.