Marijuana screening and trauma outcomes

Fujii, Quinn; Olsen, Issak; McCague, Andrew

doi:10.4103/jets.jets_6_19

Cited by 4 publications

(9 citation statements)

References 5 publications

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“…Several observational studies explored the effects of non-medical (sometimes referred to as "recreational") cannabis use. In these studies, although non-medical cannabis use was found not to compromise lung function in individuals who used tobacco [137], detrimental effects of non-medical use were identified, albeit in unadjusted analyses: older people without housing that consumed cannabis were more likely to fall [93] and older trauma patients were more likely to demonstrate early signs of shock, if they consumed cannabis [114]. Of greater prevalence in the literature were observational studies that either evaluated associations with any cannabis use (i.e., medical or non-medical; n = 14 studies) or that didn't report the type of use (n = 28 studies), with more than half of these studies analyzing large national survey data (i.e., the older general public).…”

Section: Plos Onementioning

confidence: 99%

“…In adjusted analyses, cannabis use in older adults did not impact mortality [127] or the need for intubation [127]; however, it was significantly associated with ICU admission [127] and need for an operation due to the trauma [127]. Unadjusted analyses suggested significant associations of non-medical cannabis use with lower blood pressure and higher heart rate (potentially early signs of shock) [114], and non-significant associations with consciousness/coma [114], injury severity [114], and length of stay in the hospital or ICU [114].…”

Section: Plos Onementioning

confidence: 99%

“…Fourteen other studies explicitly stated that all cannabis use, whether for medical or non-medical purposes, was evaluated [4, 97, 100, 104, 106, 108-110, 112, 116, 132, 135, 138, 144]. Fifteen NRSs focused strictly on medical use, overseen by a physician [94,98,99,101,111,120,121,131, PLOS ONE 133,136,148,149,152,156,158]; four focused strictly on non-prescribed medical use (i.e., taken for a perceived or actual medical condition, not for recreational purposes) [150,151,154,155]; and ten focused strictly on non-medical/recreational use [93,114,125,129,130,137,147,153,162]. The remaining NRS studied medical use of any kind [140].…”

Section: Interventions and Exposures Evaluated In The Included Primar...mentioning

confidence: 99%

“…Trauma. Trauma patients who used cannabis were compared to those who did not in two retrospective cohort studies [114,127]. In adjusted analyses, cannabis use in older adults did not impact mortality [127] or the need for intubation [127]; however, it was significantly associated with ICU admission [127] and need for an operation due to the trauma [127].…”

Section: Plos Onementioning

confidence: 99%

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Impacts of medical and non-medical cannabis on the health of older adults: Findings from a scoping review of the literature

et al. 2023

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Background Cannabis legalization has enabled increased consumption in older adults. Age-related mental, physical, and physiological changes may lead to differences in effects of cannabis in older adults compared to younger individuals. Objective To perform a scoping review to map the evidence regarding the health effects of cannabis use for medical and non-medical purposes in older adults. Methods Electronic databases (MEDLINE, Embase, PsycINFO, Cochrane Library) were searched for systematic reviews (SRs), randomized controlled trials (RCTs) and non-randomized/observational studies (NRSs) assessing the health effects and associations of cannabis use (medical or non-medical) in adults ≥ 50 years of age. Included studies met age-related inclusion criteria or involved a priori identified health conditions common among older adults. Records were screened using a liberal accelerated approach and data charting was performed independently by two reviewers. Descriptive summaries, structured tables, effect direction plots and bubble plots were used to synthesize study findings. Findings From 31,393 citations, 133 publications describing 134 unique studies (26 SRs, 36 RCTs, 72 NRSs) were included. Medical cannabis had inconsistent therapeutic effects in specific patient conditions (e.g., end-stage cancer, dementia), with a number of studies suggesting possible benefits while others found no benefit. For medical cannabis, harmful associations outnumbered beneficial, and RCTs reported more negative effects than NRSs. Cannabis use was associated with greater frequencies of depression, anxiety, cognitive impairment, substance use and problematic substance use, accidents/injuries, and acute healthcare use. Studies often were small, did not consistently assess harms, and did not adjust for confounding. Discussion The effects of medical cannabis are inconsistent within specific patient conditions. For older adults, generally, the available evidence suggests cannabis use may be associated with greater frequencies of mental health issues, substance use, and acute healthcare use, and the benefit-to-risk ratio is unclear. Studies with a balanced assessment of benefits and harms may guide appropriate public health messaging to balance the marketing pressures of cannabis to older adults.

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Section: Plos Onementioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

Section: Interventions and Exposures Evaluated In The Included Primar...mentioning

confidence: 99%

Section: Plos Onementioning

confidence: 99%

See 2 more Smart Citations

Impacts of medical and non-medical cannabis on the health of older adults: Findings from a scoping review of the literature

et al. 2023

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“…For example, some analyses have found an increase in mortality rates of marijuana positive patients [19], while others have reported the opposite [6] or no association [20][21][22][23]. This same pattern of results has been seen in the hospital length of stay (LOS) [20,[22][23][24][25][26][27][28], the Injury Severity Score (ISS) [19,26], and other important parameters. Due to this lack of studies and the conflicting results from the available ones, there exists no clear scientific consensus regarding the impact of drug use on trauma patient outcomes.…”

Section: Introductionmentioning

confidence: 85%

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

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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.

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Impact of cannabis on outcome in patients following traumatic injury

Ahmed

Kuo

2023

Injury

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Marijuana screening and trauma outcomes

Cited by 4 publications

References 5 publications

Impacts of medical and non-medical cannabis on the health of older adults: Findings from a scoping review of the literature

Impacts of medical and non-medical cannabis on the health of older adults: Findings from a scoping review of the literature

Trends and outcomes of trauma patients positive to marijuana and cocaine

Impact of cannabis on outcome in patients following traumatic injury

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