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Sunday Poster Session

Category: Liver

P1540 - Impact of Cannabis Use on the Outcomes of Liver Cirrhosis: A US National Retrospective Cohort Study

Sunday, October 26, 2025
3:30 PM - 7:00 PM MT
Location: Exhibit Hall
Azhar Hussain, MBBS1, Kalsoom Khalil, MBBS2, Fatima Zahra, MBBS3, Mohamad Khaled Almujarkesh, MD4, Prerna Ashok Kherajani, MBBS5, Shefali Mody, MBBS1, Avneet Kaur, MBBS1, Chidera Onwuzo, MD6, Al-Aman Shaukat, MBBS1, Hafiz Muzaffar Akbar Khan, MD6
1SUNY Upstate Medical University Hospital, Syracuse, NY; 2Ameer Ud Din Medical College, Lahore, Punjab, Pakistan; 3Aga Khan University, Karachi, Sindh, Pakistan; 4AdventHealth, Orlando, FL; 5SUNY Upstate Medical University, Syracuse, NY; 6SUNY Upstate - - Syracuse, NY - 750 East Adams StSyracuse, NY 13210UNITED STATES - Syracuse, NY, Syracuse, NY

Introduction: After the legalization of the cannabis, cannabis use has surpassed the cigarettes smoking per CDC data in 2023. There is no concrete data on the safety of cannabis use in liver cirrhosis patients and how it impacts various liver-related and other outcomes in this special set of population.

Methods: We queried the U.S. electronic health record data from the TriNetX network for patients aged 18-89 years with liver cirrhosis, and categorized them into 2 cohorts (cohort 1: cirrhosis + cannabis use disorder; cohort 2: cirrhosis - cannabis use disorder). Propensity score matching (PSM) was conducted for demographic variables and key laboratory values. Outcomes were assessed over a 1 year follow-up period and included infectious complications, liver-related outcomes, all-cause mortality, and healthcare utilization.

Results: After propensity matching, 45,022 patients were included in each cohort. Patients with cirrhosis and cannabis use disorder had significantly higher risks of dehydration (OR 1.470, 95% CI 1.399-1.544), sepsis (OR 1.315, 95% CI 1.260- 1.374), septic shock (OR 1.303, 95% CI 1.248-1.361), SBP (OR 1.228, 95% CI 1.140-1.322), pneumonia (OR 1.314, 95% CI 1.254-1.376), hepatic encephalopathy (OR 1.158, 95% CI 1.097-1.223), and acute kidney injury (OR 1.240, 95% CI 1.192-1.290) compared to no cannabis users. Cannabis use in liver cirrhosis was associated with higher odds of inpatient hospitalization (OR 1.405, 95% CI 1.386-1.424), and ER visits (OR 1.424, 95% CI 1.398-1.450) than non-users. All-cause mortality (OR 1.103, 95% CI 1.068-1.139) was higher but liver transplantation rates (OR 0.568, 95% CI 0.524-0.616) were lower in the cannabis use cohort than non-users (Table 1).

Discussion: Our study identifies the increased risk of adverse clinical outcomes associated with cannabis use disorder in liver cirrhosis patients. This may be attributed to the effects of cannabis on cardiovascular function, neuromodulation and suppression, immune modulation, and gastrointestinal motility which may predispose vulnerable cirrhotic patients to complications like dehydration, AKI, encephalopathy, and infectious complications and hence lead to increased healthcare utilization. Cannabis use ultimately led to worsened all-cause mortality in this special subset of the population, highlighting the need for increased awareness and education of both patients and physicians equally, on the detrimental effects of cannabis use in liver cirrhosis.


Figure: Table 1: Primary and secondary outcomes among cannabis users vs. non-cannabis users in liver cirrhosis

Disclosures:
Azhar Hussain indicated no relevant financial relationships.
Kalsoom Khalil indicated no relevant financial relationships.
Fatima Zahra indicated no relevant financial relationships.
Mohamad Khaled Almujarkesh indicated no relevant financial relationships.
Prerna Ashok Kherajani indicated no relevant financial relationships.
Shefali Mody indicated no relevant financial relationships.
Avneet Kaur indicated no relevant financial relationships.
Chidera Onwuzo indicated no relevant financial relationships.
Al-Aman Shaukat indicated no relevant financial relationships.
Hafiz Muzaffar Akbar Khan indicated no relevant financial relationships.

Azhar Hussain, MBBS1, Kalsoom Khalil, MBBS2, Fatima Zahra, MBBS3, Mohamad Khaled Almujarkesh, MD4, Prerna Ashok Kherajani, MBBS5, Shefali Mody, MBBS1, Avneet Kaur, MBBS1, Chidera Onwuzo, MD6, Al-Aman Shaukat, MBBS1, Hafiz Muzaffar Akbar Khan, MD6. P1540 - Impact of Cannabis Use on the Outcomes of Liver Cirrhosis: A US National Retrospective Cohort Study, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.