K. R. AbdelFattah1, C. R. Edwards1, M. W. Cripps1, C. T. Minshall1, H. A. Phelan1, J. P. Minei1, A. L. Eastman1 1University Of Texas Southwestern Medical Center,Burns, Trauma, And Critical Care Surgery,Dallas, TX, USA
Introduction: Since 1996, 22 states have legalized medical marijuana (MJ) use and two have legalized recreational use. With more states considering legislation to legalize the use of the drug, emergency responders and facilities recieving these patients need to understand the impact on acute injuries. The effects of MJ use on injured patients has not been thoroughly evaluated. Our group sought to evaluate the effects of cannabis use at the time of severe injury on hospital course and patient outcomes.
Methods: A retrospective chart review was undertaken at an urban Level 1 Trauma Center covering a two-year period. Patients presenting with an ISS>16 were divided into four groups based on urine drug screen results. Negative urine drug screen patients represented our control group. Positive subjects were subdivided into marijuana-only (MO), other-drugs only (OD), and mixed-use (MU) groups. These groups were compared for differences in presenting characteristics, hospital length of stay, ICU stays, ventilator days, and death.
Results: 8441 subjects presented during the study period, of which 2134 had drug testing performed. 843(40%) had an ISS>16, with 347(41%) having negative tests (NEG). 70(14%) tested positive for marijuana only (MO), 325 (65%) for drugs other than marijuana (OD), and 103 (21%) subjects showed mixed-use (MU). Alcohol levels were higher in the MO group than any other group (p<0.05) No differences were seen in presenting GCS, ICU/hospital length of stay, ventilator days, and blood administration when comparing the MO group to the NEG group. Significant differences were found between the OD group and the NEG/MO/MU groups for presenting GCS (OD 9.7 vs NEG 11.9, MO 12.4, MU 10.7, p<0.05), ICU days (OD 6.0 vs NEG 4.7, MO 4.6, MU 3.7, p<0.05) and hospital days (OD 14.2 vs. NEG 12.0, MO 12.0, MU 10.5 p<0.05), and hospital charges (OD 182k vs. NEG 147k, MO 157k, MU 132k p<0.05).
Conclusion: Cannabis users suffering severe injury demonstrated no acute detrimental outcomes in this study compared with non-drug users. With regards to presenting GCS, ICU/hospital length of stay, and hospital charges, marijuana, alone or in combination with other drugs appeared more similar to the NEG group rather than the OD group.