1742: Marijuana Exposure Is Associated With Hypercoagulability After Injury

Carter, Kristen; Patki, Deepti; Kutcher, Matthew

doi:10.1097/01.ccm.0000552480.72934.01

Cited by 3 publications

(1 citation statement)

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“…These findings of increased venous clotting in heavy cannabis users are consistent with a small study of 25 critically injured trauma patients that found that patients who had a positive urine drug screen for marijuana demonstrated a higher level of coagulability on thromboelastography (TEG) at admission compared with those without a positive drug screen 51 . Interestingly, current tobacco use, recent alcohol use, and recent cocaine use had no relationship with hypercoagulability in this study.…”

Section: Venous Thromboembolismsupporting

confidence: 85%

Effects of Marijuana Use in Patients with Orthopaedic Trauma

et al. 2021

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The use of cannabis and cannabis-related products has increased dramatically in the last 2 decades. As states continue to legalize cannabis products, it is important for surgeons to understand the effects they may have on patients who have sustained orthopaedic trauma.Cannabinoids have been shown to decrease the severity of certain symptoms related to traumatic brain injury as well as posttraumatic stress disorder.Cannabinoids can modulate the body’s endocannabinoid system, which can play an important role in bone homeostasis. Activation of cannabinoid receptors has been shown to be bone-protective in adults.Venous thromboembolism is a major concern for trauma patients. Cannabis use has been linked to overall increased rates of venous thromboembolism events.Literature regarding human-based cannabis studies is sparse; however, the growing field is opening new opportunities for research of this topic.

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Section: Venous Thromboembolismsupporting

confidence: 85%

Effects of Marijuana Use in Patients with Orthopaedic Trauma

et al. 2021

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Marijuana and thromboembolic events in geriatric trauma patients: The cannabinoids clots correlation!

Asmar

Nelson

Anand

et al. 2022

The American Journal of Surgery

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Impact of marijuana on venous thromboembolic events: Cannabinoids cause clots in trauma patients

Stupinski

Bible

Asmar

et al. 2020

J Trauma Acute Care Surg

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BACKGROUND Tetrahydrocannabinoids (THC) can modulate the coagulation cascade resulting in hypercoagulability. However, the clinical relevance of these findings has not been investigated. The aim of our study was to evaluate the impact of preinjury marijuana exposure on thromboembolic complications (TEC) in trauma patients. METHODS We performed a 2-year (2015–2016) analysis of American College of Surgeons Trauma Quality and Improvement Program database and included all adult (≥18 year) trauma patients. Patients were stratified based on preinjury exposure to Marijuana: THC + ve and THC −ve groups. We performed propensity score matching to control for confounding variables: demographics, comorbidities, injury parameters, hospital course, and thromboprophylaxis use. Outcomes were TEC (deep venous thrombosis, pulmonary embolism, stroke, myocardial infarction) and mortality. RESULTS Of 593,818 trauma patients, 678 patients were matched (THC + ve: 226 vs. THC −ve: 452). Mean age was 34 ± 15 years, Injury Severity Score was 14 (10–21). There was no difference between the two groups regarding age (p = 0.75), sex (p = 0.99), Injury Severity Score (p = 0.54), spine Abbreviated Injury Scale (AIS) (p = 0.61), head AIS (p = 0.32), extremities AIS (p = 0.38), use of unfractionated heparin (p = 0.54), use of low molecular weight heparin (p = 0.54), and hospital length of stay (p = 0.87). Overall, the rate of TEC was 4.3% and mortality was 4%. Patients in THC + ve group had higher rates of TEC compared with those in THC −ve group (3.5% vs. 1.1%, p = 0.03). The rate of deep venous thrombosis (6.6% vs. 1.8%, p = 0.02) and PE (2.2% vs. 0.2%, p = 0.04) was higher in THC + ve group. However, there was no difference regarding the rate of stroke (p = 0.24), myocardial infarction (p = 0.35) and mortality (p = 0.28). CONCLUSION THC exposure increases the risk of TEC in patients with trauma. Early identification and treatment for TEC is required to improve outcomes in this high-risk subset of trauma patients. LEVEL OF EVIDENCE Prognostic study, level III.

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1742: Marijuana Exposure Is Associated With Hypercoagulability After Injury

Cited by 3 publications

References 0 publications

Effects of Marijuana Use in Patients with Orthopaedic Trauma

Effects of Marijuana Use in Patients with Orthopaedic Trauma

Marijuana and thromboembolic events in geriatric trauma patients: The cannabinoids clots correlation!

Impact of marijuana on venous thromboembolic events: Cannabinoids cause clots in trauma patients

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