J. Hannallah1, P. Rhee1, K. M. Ibraheem1, N. Kulvatunyou1, T. O’Keeffe1, A. Tang1, R. Latifi1, L. Gries1, D. J. Green1, R. Friese1, B. Joseph1 1University Of Arizona,Trauma Surgery,Tucson, AZ, USA
Introduction: The prevalence of marijuana abuse and dependence has been increasing among adults and adolescents trauma patients in the United States. Several studies have demonstrated effects of marijuana on the outcomes of diseases. The aim of this study was to assess the relationship between the presence of a positive toxicology screen for marijuana and mortality in trauma patients.
Methods: We performed a 5-year (2008-2012) retrospective analysis of adult trauma patients (>18 y/o) using the Arizona State Trauma database. We included patients admitted to the ICU with a positive toxicology screen for marijuana. We excluded patients with positive alcohol or other substance screening. Patient demographics, injury and vital parameters, and toxicology data were collected. Our outcome measures were mortality, ventilator days, and ICU and hospital length of stay. We matched the patients who were positive for marijuana (marijuana positive) to the ones who were negative (marijuana negative) using propensity score matching in a 1:1 ratio controlling for age, injury severity score, and GCS. We compared the outcomes in matched groups.
Results:A total of 24,535 patients were included in our analysis of which 1,938 (969: marijuana positive, 969: marijuana negative) were matched. Rate of positive screening for marijuana was 5.3% in trauma population. Mean age was 31 ± 14, 80% were male, and median ISS [IQR] was 19 [9 – 25]. There was no difference in hospital (6.6 ± 8.6 vs. 7.3 ± 9.0, p=0.09) or ICU (2.9 ± 5.6 vs. 3.4 ± 5.3, p=0.08) length of stay or total ventilation days (2.8 ± 6.5 vs. 2.9 ± 5.3, p=0.88) between the two groups. 37% of the marijuana positive patients were under ventilator compared to 27% of marijuana negative patients (p < 0.001). Patients with positive screening for marijuana had a lower mortality rate (4.7% vs. 7.2%, p=0.04) compared to patients who were negative on toxicology screening.
Conclusion:A positive marijuana screen is associated with decreased mortality in adult trauma patients on ventilator. This association warrants further investigation of the possible physiological effects of marijuana in trauma patients.