TY  - JOUR
PY  - 2017//
TI  - How does marijuana effect outcomes after trauma in ICU patients? A propensity matched analysis
JO  - Journal of trauma and acute care surgery
A1  - Singer, Matt
A1  - Azim, Asad
A1  - O'Keeffe, Terence
A1  - Khan, Muhammad
A1  - Jain, Arpana
A1  - Kulvatunyou, Narong
A1  - Gries, Lynn
A1  - Jehan, Faisal
A1  - Tang, Andrew
A1  - Joseph, Bellal
SP  - 846
EP  - 849
VL  - 83
IS  - 5
N2  - INTRODUCTION: In US, marijuana abuse and dependence are becoming more prevalent among adult and adolescent trauma patients. Unlike several studies that focus on the effects of marijuana on the outcomes of diseases, our aim was to assess the relationship between a positive toxicology screen for marijuana and mortality in such patients. <br><br>METHODS: A 5-year (2008-2012) analysis of adult trauma patients (>18 y/o) in Arizona State Trauma Registry. We included patients admitted to the intensive care unit (ICU) with a positive toxicology screen for marijuana. We excluded patients with positive alcohol or other substance screening. Outcome measures were mortality, ventilator days, ICU, and hospital Length of Stay (LOS). We matched patients who were positive for marijuana (marijuana positive) to those who were negative (marijuana negative) using propensity score matching in a 1:1 ratio controlling for age, injury severity score (ISS), and Glasgow-Coma-Scale (GCS). <br><br>RESULTS: We included a total of 28,813 patients, of which 2,678 were matched (1,339: marijuana positive, 1,339: marijuana negative). The rate of positive screening for marijuana was 7.4% (2,127/28,813). Mean age was 31±9y, and ISS was 13 [8-20]. There was no difference between the two groups in hospital (6.4d vs. 5.4d, p=0.08) or ICU (3d vs. 4d, p=0.43) LOS. 55.3% of the marijuana positive, while 32% of marijuana negative patients received mechanical ventilation (p< 0.001). On sub analysis of patients who received mechanical ventilation, marijuana positive had a higher number of ventilator days (2d vs. 1d, p=0.02) and a lower mortality rate (7.3% vs. 16.1%, p<0.001) than those who were marijuana negative. <br><br>CONCLUSION: A positive marijuana screen is associated with decreased mortality in adult trauma patients admitted to the ICU. This association warrants further investigation of the possible physiological effects of marijuana in trauma patients. LEVEL OF EVIDENCE: Level III, Prognostic studies.<p />  <p>Language: en</p>
LA  - en
SN  - 2163-0755
UR  - http://dx.doi.org/10.1097/TA.0000000000001672
ID  - ref1
ER  -