@article{ref1,
title="Severe outcomes following pediatric cannabis intoxication: a prospective cohort study of an international toxicology surveillance registry",
journal="Clinical toxicology (Philadelphia, Pa.)",
year="2023",
author="Cohen, Neta and Mathew, Mathew and Brent, Jeffrey and Wax, Paul and Davis, Adrienne L. and Obilom, Cherie and Burns, Michele M. and Canning, Joshua and Baumgartner, Kevin and Koons, Andrew L. and Wiegand, Timothy J. and Judge, Bryan and Hoyte, Christopher and Chenoweth, James A. and Froberg, Blake and Farrar, Henry and Carey, Jennifer L. and Hendrickson, Robert G. and Hodgman, Michael and Caravati, E. Martin and Christian, Michael R. and Wolk, Brian J. and Seifert, Steven A. and Bentur, Yedidia and Levine, Michael and Farrugia, Lynn A. and Vearrier, David and Minns, Alicia B. and Kennedy, Joseph M. and Kirschner, Ron I. and Aldy, Kim and Schuh, Suzanne and Campleman, Sharan and Li, Shao and Myran, Daniel T. and Feng, Lisa and Freedman, Stephen B. and Finkelstein, Yaron",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="INTRODUCTION: An increasing number of jurisdictions have legalized recreational cannabis for adult use. The subsequent availability and marketing of recreational cannabis has led to a parallel increase in rates and severity of pediatric cannabis intoxications. We explored predictors of severe outcomes in pediatric patients who presented to the emergency department with cannabis intoxication. <br><br>METHODS: In this prospective cohort study, we collected data on all pediatric patients (<18 years) who presented with cannabis intoxication from August 2017 through June 2020 to participating sites in the Toxicology Investigators Consortium. In cases that involved polysubstance exposure, patients were included if cannabis was a significant contributing agent. The primary outcome was a composite severe outcome endpoint, defined as an intensive care unit admission or in-hospital death. Covariates included relevant sociodemographic and exposure characteristics. <br><br>RESULTS: One hundred and thirty-eight pediatric patients (54% males, median age 14.0 years, interquartile range 3.7-16.0) presented to a participating emergency department with cannabis intoxication. Fifty-two patients (38%) were admitted to an intensive care unit, including one patient who died. In the multivariable logistic regression analysis, polysubstance ingestion (adjusted odds ratio = 16.3; 95% confidence interval: 4.6-58.3; P < 0.001)) and cannabis edibles ingestion (adjusted odds ratio = 5.5; 95% confidence interval: 1.9-15.9; P = 0.001) were strong independent predictors of severe outcome. In an age-stratified regression analysis, in children older than >10 years, only polysubstance abuse remained an independent predictor for the severe outcome (adjusted odds ratio 37.1; 95% confidence interval: 6.2-221.2; P < 0.001). As all children 10 years and younger ingested edibles, a dedicated multivariable analysis could not be performed (unadjusted odds ratio 3.3; 95% confidence interval: 1.6-6.7). <br><br>CONCLUSIONS: Severe outcomes occurred for different reasons and were largely associated with the patient's age. Young children, all of whom were exposed to edibles, were at higher risk of severe outcomes. Teenagers with severe outcomes were frequently involved in polysubstance exposure, while psychosocial factors may have played a role.<p /> <p>Language: en</p>",
language="en",
issn="1556-3650",
doi="10.1080/15563650.2023.2238121",
url="http://dx.doi.org/10.1080/15563650.2023.2238121"
}