Effect of Marijuana Use on Outcomes in Traumatic Brain Injury

Abstract

Traumatic brain injury (TBI) is associated with significant morbidity and mortality. Several studies have demonstrated neuroprotective effects of cannabinoids. The objective of this study was to establish a relationship between the presence of a positive toxicology screen for tetrahydrocannabinol (THC) and mortality after TBI. A 3-year retrospective review of registry data at a Level I center of patients sustaining TBI having a toxicology screen was performed. Pediatric patients (younger than 15 years) and patients with a suspected nonsurvivable injury were excluded. The THC(+) group was compared with the THC(-) group with respect to injury mechanism, severity, disposition, and mortality. Logistic regression was used to determine independent associations with mortality. There were 446 cases meeting all inclusion criteria. The incidence of a positive THC screen was 18.4 per cent (82). Overall mortality was 9.9 per cent (44); however, mortality in the THC(+) group (2.4% [two]) was significantly decreased compared with the THC(-) group (11.5% [42]; P = 0.012). After adjusting for differences between the study cohorts on logistic regression, a THC(+) screen was independently associated with survival after TBI (odds ratio, 0.224; 95% confidence interval, 0.051 to 0.991; P = 0.049). A positive THC screen is associated with decreased mortality in adult patients sustaining TBI.

Medicinal Properties of Cannabinoids, Terpenes, and Flavonoids in Cannabis, and Benefits in Migraine, Headache, and Pain: An Update on Current Evidence and Cannabis Science

“…These 2 synthetic forms of THC have also been shown to have analgesic benefit . ‐ There have been other benefits of THC reported also, including antioxidant and neuroprotective, Alzheimer's disease, amyotrophic lateral sclerosis (ALS), MS, ‐ autism, Parkinson's, Tourette's syndrome, Huntington's disease/chorea, depression, posttraumatic stress disorder (PTSD), sickle cell disease pain, traumatic brain injury (TBI), hypothermia, duodenal ulcers, anorexia and cachexia, inflammatory bowel disease, spinal cord injury, antispasmodic, muscle relaxation, and spasticity, antibacterial effects against methicillin‐resistant Staphylococcus aureus (MRSA) strains, anti‐proliferative/pro‐apoptotic against tumor cell lines of multiple organ systems including brain, breast, colon, and blood, psoriasis,…”

Comorbidity in adults with traumatic brain injury and all-cause mortality: a systematic review

“…These studies were penalised because of biases on multiple levels, four or more out of seven criteria of biases. A total of 2722–48 studies, all of ‘moderate’ quality, were included for data analysis (figure 1).…”

“…A summary of the included studies is presented in Table 1, online supplementary tables 3 and 4. Among the 27 studies, 14 were population based23 25 26 28 29 33–37 40 41 44 45 and 13 were clinical studies 22 24 27 30–32 38 39 42 43 46–48. Of the 14 population-based studies, all but one used a retrospective cohort design 29.…”

“…Of the 14 population-based studies, all but one used a retrospective cohort design 29. Of the 13 clinical studies, four used a prospective cohort methodology22 27 39 43 and nine used a retrospective cohort methodology 24 30–32 38 42 46. With respect to TBI severity, 10 studies included patients of all TBI severities,29 32 33 35–37 39 41 43 46 six studies included moderate and severe TBI cases,24 30 38 45 47 48 and one study included patients with mild TBI 22.…”

Effects of endocannabinoid system, synthetic and nonsynthetic cannabinoid drugs on traumatic brain injury outcome: a narrative review

“…In a retrospective review of registered data, adult patients with TBI were investigated for toxicology screen for THC. Moreover, the relationship between the mortality rate after TBI and THC positive screen test was studied (97). The results showed that the mortality rate in the positive THC screen group was significantly decreased, compared to that in the negative THC screen group.…”