Use of marijuana could be contributing to worsening outcomes among patients hospitalized with
Results of the study, which included data from more than 13,000 heart failure admissions, suggested marijuana users had a 19% increased adjusted odds of readmission and 60% increased adjusted odds of death during index admission relative to their counterparts without marijuana use.1
“Marijuana use among patients admitted for heart failure is independently associated with increased 30-day readmission rates, despite lower overall comorbidity burdens and younger age. With increasing legalization and social acceptance of marijuana use, clinicians should be aware of this association,” wrote lead investigator Sachin Prasad, DO, of Jefferson Health, and team.1
As marijuana use becomes increasingly common, its impact on outcomes in patients hospitalized with heart failure remains an important area of investigation. According to research published in the American Journal of Public Health in 2024, reported use of cannabis within the past year has grown to approximately 25% among the US population, with 11% reporting daily use. Further elucidating this growing issue, this same study reported a decrease in the perceived risk of harm associated with marijuana use among adolescents and adults.2
To further explore the relationship between marijuana use and outcomes among patients hospitalized with heart failure, investigators launched an analysis of the National Readmission Database to explore whether marijuana use is independently associated with higher 30-day readmission rates. Using data from 2021–2022, investigators identified 13,132 non-elective heart failure admissions with concurrent marijuana use and stratified outcomes against non-users.1
The primary outcome of interest for the study was 30-day all-cause readmission, with secondary outcomes of interest including index admission mortality, time to readmission, length of stay, total charges, and socioeconomic status. Investigators noted propensity score matching was employed to adjust for baseline differences.1
Upon analysis, patients with marijuana-associated heart failure admissions were younger (mean age 52.3 vs 71.1 years; P <.005), more often male (77.9% vs 52.6%; P <.005), and more likely to use tobacco (55.2% vs 13.3%; P <.005) and reside in the lowest income quartile (52.1% vs 32.6%; P <.005).1
Investigators found marijuana use was associated with a 19% increased adjusted odds of 30-day readmission compared with non-users (25.6% vs 21.5%; adjusted Odds Ratio [aOR], 1.19; P <.005). In contrast, index admission mortality was higher among non-users (aOR 1.6; P <.005), who also had greater comorbidity burden (Charlson score 4.1 vs 3.3; P <.005).1
Further analysis revealed marijuana users were more likely to have heart failure with reduced ejection fraction (aOR, 1.41; P <.005) and be uninsured (OR, 5.5; P <.005). These patients had slightly shorter length of stay (5.2 vs 5.9 days; P = .023) and time to readmission (25.7 vs 26.6 days; P = .030), with no difference in total charges (P = .25).1
“Marijuana users represent a socioeconomically vulnerable population more likely to have reduced ejection fraction and lack insurance coverage,” Prasad and colleagues concluded.1 “These findings emphasize the need for targeted clinical and social interventions to mitigate increased readmissions and improve outcomes in this expanding patient population.”
References:
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Prasad S. The Emerging Impact Of Marijuana Use On Heart Failure Outcomes: A Nationwide Analysis. Presented at the Heart Failure Society of America (HFSA) Annual Scientific Meeting 2025. Minneapolis, MN. September 26-29, 2025.
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Baldwin GT, Vivolo-Kantor A, Hoots B, Roehler DR, Ko JY. Current Cannabis Use in the United States: Implications for Public Health Research. Am J Public Health. 2024;114(S8):S624-S627. doi:
10.2105/AJPH.2024.307823