Citation

Singer M, Azim A, O'Keeffe T, Khan M, Jain A, Kulvatunyou N, Gries L, Jehan F, Tang A, Joseph B. J. Trauma Acute Care Surg. 2017; 83(5): 846-849.

Affiliation

Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, Arizona.

Copyright

(Copyright © 2017, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000001672

PMID

28787375

Abstract

INTRODUCTION: In US, marijuana abuse and dependence are becoming more prevalent among adult and adolescent trauma patients. Unlike several studies that focus on the effects of marijuana on the outcomes of diseases, our aim was to assess the relationship between a positive toxicology screen for marijuana and mortality in such patients.

METHODS: A 5-year (2008-2012) analysis of adult trauma patients (>18 y/o) in Arizona State Trauma Registry. We included patients admitted to the intensive care unit (ICU) with a positive toxicology screen for marijuana. We excluded patients with positive alcohol or other substance screening. Outcome measures were mortality, ventilator days, ICU, and hospital Length of Stay (LOS). We matched patients who were positive for marijuana (marijuana positive) to those who were negative (marijuana negative) using propensity score matching in a 1:1 ratio controlling for age, injury severity score (ISS), and Glasgow-Coma-Scale (GCS).

RESULTS: We included a total of 28,813 patients, of which 2,678 were matched (1,339: marijuana positive, 1,339: marijuana negative). The rate of positive screening for marijuana was 7.4% (2,127/28,813). Mean age was 31±9y, and ISS was 13 [8-20]. There was no difference between the two groups in hospital (6.4d vs. 5.4d, p=0.08) or ICU (3d vs. 4d, p=0.43) LOS. 55.3% of the marijuana positive, while 32% of marijuana negative patients received mechanical ventilation (p< 0.001). On sub analysis of patients who received mechanical ventilation, marijuana positive had a higher number of ventilator days (2d vs. 1d, p=0.02) and a lower mortality rate (7.3% vs. 16.1%, p<0.001) than those who were marijuana negative.

CONCLUSION: A positive marijuana screen is associated with decreased mortality in adult trauma patients admitted to the ICU. This association warrants further investigation of the possible physiological effects of marijuana in trauma patients. LEVEL OF EVIDENCE: Level III, Prognostic studies.

Language: en