Cannabis Use is Associated with Increased Mechanical Ventilation and Polysubstance Use in Trauma Patients

Banks, Kian C.; Biswas, Subarna; Wong, Monica; Byerly, Saskya; Clark, Damon; Lam, Lydia; Inaba, Kenji; Δημητριάδης, Δημήτριος

doi:10.1177/000313481908500234

Cited by 13 publications

(22 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…THC + patients were more likely to be young males and were less likely to wear seatbelts, which is in agreement with the characteristics of THC + patients described in similar reports. 20 Overall, THC or any other positive toxicology was associated with an increased ISS compared with TOX–, although the odds of having an increased ISS was higher in the THC +ETOH patients than ETOH + patients for all ISS categories. This suggests that the combined use of alcohol and THC may have a synergistic effect on driver impairment, translating to worse injuries.…”

Section: Discussionmentioning

confidence: 84%

“… 19 Cannabis positivity in trauma patients has also been shown to be associated with increased hospital length of stay, intensive care unit days, ventilator days, and a greater number of operative interventions. 20 21 Conversely, studies by Movig and Longo reported that marijuana intoxication may not even be associated with an increased risk of motor vehicle crashes. 22 23 …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Driving under the influence: a multi-center evaluation of vehicular crashes in the era of cannabis legalization

Borst

Costantini

Reilly

et al. 2021

Trauma Surg Acute Care Open

View full text Add to dashboard Cite

BackgroundEleven states have instituted laws allowing recreational cannabis use leading to growing public health concerns surrounding the effects of cannabis intoxication on driving safety. We hypothesized that after the 2016 legalization of cannabis in California, the use among vehicular injury patients would increase and be associated with increased injury severity.MethodsSan Diego County’s five adult trauma center registries in were queried from January 2010 to June 2018 for motor vehicle or motorcycle crash patients with completed toxicology screens. Patients were stratified as toxicology negative (TOX−), positive for only THC (THC+), only blood alcohol >0.08% (ETOH+), THC+ETOH, or THC+ with any combination with methamphetamine or cocaine (M/C). County medical examiner data were reviewed to characterize THC use in those with deaths at the scene of injury.ResultsOf the 11,491 patients identified, there were 61.6% TOX−, 11.7% THC+, 13.7% ETOH+, 5.0% THC+ETOH, and 7.9% M/C. THC+ increased from 7.3% to 14.8% over the study period and peaked at 14.9% post-legalization in 2017. Compared with TOX− patients, THC+ patients were more likely to be male and younger. THC+ patients were also less likely to wear seatbelts (8.5% vs 14.3%, p<0.001) and had increased mean Injury Severity Score (8.4±9.4 vs 9.0±9.9, p<0.001) when compared with TOX− patients. There was no difference in in-hospital mortality between groups. From the medical examiner data of the 777 deaths on scene, 27% were THC+.DiscussionTHC+ toxicology screens in vehicular injury patients peaked after the 2016 legalization of cannabis. Public education on the risks of driving under the influence of cannabis should be a component of injury prevention initiatives.Level of evidenceIII, Prognostic

show abstract

Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Driving under the influence: a multi-center evaluation of vehicular crashes in the era of cannabis legalization

Borst

Costantini

Reilly

et al. 2021

Trauma Surg Acute Care Open

View full text Add to dashboard Cite

show abstract

“…There were 100 records that reported on the prevalence of AOD involvement in injury events. Of the 100 records that reported on all causes of injury (excluding transport events), 30 studies reported on the prevalence of AOD involvement in patients presenting to hospital after falls 24–52. One of these studies was excluded, since it reported exclusively on patients who denied consuming alcohol in the past year 38.…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, several papers examined overlapping datasets, including two studies each from the National Trauma Data Bank in the USA,27 44 the Oslo University Hospital Emergency Department,25 30 the R Adams Cowley Shock Trauma Centre24 48 and a trauma centre in Taiwan 32 45. Two papers obtained data from the Los Angeles County database, but used datasets with non-overlapping timeframes 26 49…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of alcohol and other drug use in patients presenting to hospital for fall-related injuries: a systematic review

et al. 2022

View full text Add to dashboard Cite

BackgroundAlcohol and other drug (AOD) use is a key preventable risk factor for serious injuries. Prevention strategies to date have largely focused on transport injuries, despite AOD use being a significant risk factor for other injury causes, including falls. This systematic review aimed to report the prevalence of AOD use in patients presenting to hospital for fall-related injuries.MethodsThis systematic review includes studies published in English after the year 2010 that objectively measured the prevalence of AOD use in patients presenting to hospital for a fall-related injury. Screening, data extraction and risk of bias assessments were completed by two independent reviewers. Data were presented using narrative synthesis and, where appropriate, meta-analyses.ResultsA total of 12 707 records were screened. Full texts were retrieved for 2042 records, of which 29 were included. Four studies reported the combined prevalence of any alcohol and/or drug use, generating a pooled prevalence estimate of 37% (95% CI 25% to 49%). Twenty-two records reported on the prevalence of acute alcohol use alone and nine reported specifically on the prevalence of drugs other than alcohol, with prevalence ranging from 2% to 57% and 7% to 46%, respectively. The variation in prevalence estimates likely resulted from differences in toxicology testing methods across studies.ConclusionsAOD exposure was common in hospitalised fall-related injuries. However, research addressing prevalence across different types of falls and the use of drugs other than alcohol was limited. Future research should address these areas to improve our understanding of which populations should be targeted in AOD and injury prevention strategies .PROSPERO registration numberCRD42020188746.

show abstract

Trends and outcomes of trauma patients positive to marijuana and cocaine

Roque-Torres

Ramírez-Martínez

Ramos-Meléndez

et al. 2023

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

Purpose Substance misuse has long been recognized as a major predisposing risk factor for traumatic injury. However, there still exists no clear scientific consensus regarding the impact of drug use on patient outcomes. Therefore, this study aims to evaluate the demographic profile, hospital-course factors, and outcomes of trauma patients based on their toxicology. Methods This is a non-concurrent cohort study of 3709 patients treated at the Puerto Rico Trauma Hospital during 2002–2018. The sample was divided into four groups according to their toxicology status. Statistical techniques used included Pearson’s chi-square test, Spearman correlation, and negative binomial and logistic regressions. Results Admission rates for marijuana (rho = 0.87) and marijuana and cocaine positive (rho = 0.68) patients increased. Positive toxicology patients underwent surgery more often than negative testing patients (marijuana: 68.7%, cocaine: 65.6%, marijuana & cocaine: 69.8%, negative: 57.0%). Among patients with non-penetrating injuries, a positive toxicology for cocaine or marijuana was linked to a 48% and 42% increased adjusted risk of complications, 37% and 27% longer TICU LOS, and 32% and 18% longer hospital LOS, respectively. Conclusion Our results show an association between positive toxicology for either marijuana, cocaine, or both with higher need for surgery. Additionally, our results show an increase in complications, TICU LOS, and hospital LOS among non-penetrating trauma patients testing positive for marijuana or cocaine. Therefore, this study provides valuable information on the clinical profile of patients with positive toxicology, suggesting they might benefit from more aggressive management.

show abstract

Cannabis Use is Associated with Increased Mechanical Ventilation and Polysubstance Use in Trauma Patients

Cited by 13 publications

References 19 publications

Driving under the influence: a multi-center evaluation of vehicular crashes in the era of cannabis legalization

Driving under the influence: a multi-center evaluation of vehicular crashes in the era of cannabis legalization

Prevalence of alcohol and other drug use in patients presenting to hospital for fall-related injuries: a systematic review

Trends and outcomes of trauma patients positive to marijuana and cocaine

Contact Info

Product

Resources

About