S1719 Cannabis Use and 30-Day Readmission in Inflammatory Bowel Disease: A Nationwide Analysis

Introduction: Thirty-day readmissions following hospitalization for ulcerative colitis (UC) or Crohn’s disease (CD) impose significant clinical and economic burden. Cannabis is increasingly used by patients for symptom and pain management, but its effect on readmission outcomes remains unclear. Methods: We conducted a retrospective cohort study using the 2021 Nationwide Readmissions Database. Adult hospitalizations for UC and CD were identified using International Classification of Diseases-10 codes. Index admissions excluded December discharges, and unplanned 30-day readmissions were assessed. Survey-weighted logistic regression models were used separately for UC, CD, and the overall IBD cohort to estimate odds ratios (ORs) for 30-day readmission associated with cannabis use. Models adjusted for age, sex, tobacco use, primary payer, ZIP-code income quartile, length of stay, elective and weekend admission, hospital teaching status, urban–rural category, hospital bed size, and Elixhauser comorbidity score. Results: Ulcerative colitis (n = 12,500; weighted population = 23,395): Cannabis use was associated with a 30% reduction in the odds of 30-day readmission (OR 0.70; 95% CI 0.49–0.98; P = 0.039). Female sex was protective, while elective admission, longer hospital stay, and higher comorbidity burden were associated with increased risk. Tobacco use was not significantly associated with readmission. Crohn’s disease (n = 18,363; weighted population = 35,993): Cannabis use was not significantly associated with 30-day readmission (OR 0.99; 95% CI 0.79–1.24; P = 0.915). Elective admission and older age were associated with reduced risk, while longer hospital stay and higher comorbidity burden were associated with increased readmission risk. Tobacco use was not a significant predictor. IBD cohort (n = 30,863; weighted population = 59,389): Cannabis use was not significantly associated with 30-day readmission (OR 0.90; 95% CI 0.75–1.09; P = 0.269). Older age, female sex, and Medicaid insurance were associated with reduced risk, while longer hospital stay and higher comorbidity burden increased readmission risk. Conclusion: In this nationally representative sample, cannabis use was associated with a significant 30% reduction in 30-day readmission odds among patients hospitalized with ulcerative colitis that warrants further investigation. No such association was found among patients with Crohn’s disease.