TY  - JOUR
PY  - 2023//
TI  - Severe outcomes following pediatric cannabis intoxication: a prospective cohort study of an international toxicology surveillance registry
JO  - Clinical toxicology (Philadelphia, Pa.)
A1  - Cohen, Neta
A1  - Mathew, Mathew
A1  - Brent, Jeffrey
A1  - Wax, Paul
A1  - Davis, Adrienne L.
A1  - Obilom, Cherie
A1  - Burns, Michele M.
A1  - Canning, Joshua
A1  - Baumgartner, Kevin
A1  - Koons, Andrew L.
A1  - Wiegand, Timothy J.
A1  - Judge, Bryan
A1  - Hoyte, Christopher
A1  - Chenoweth, James A.
A1  - Froberg, Blake
A1  - Farrar, Henry
A1  - Carey, Jennifer L.
A1  - Hendrickson, Robert G.
A1  - Hodgman, Michael
A1  - Caravati, E. Martin
A1  - Christian, Michael R.
A1  - Wolk, Brian J.
A1  - Seifert, Steven A.
A1  - Bentur, Yedidia
A1  - Levine, Michael
A1  - Farrugia, Lynn A.
A1  - Vearrier, David
A1  - Minns, Alicia B.
A1  - Kennedy, Joseph M.
A1  - Kirschner, Ron I.
A1  - Aldy, Kim
A1  - Schuh, Suzanne
A1  - Campleman, Sharan
A1  - Li, Shao
A1  - Myran, Daniel T.
A1  - Feng, Lisa
A1  - Freedman, Stephen B.
A1  - Finkelstein, Yaron
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 1556-3650
UR  - http://dx.doi.org/10.1080/15563650.2023.2238121
ID  - ref1
ER  -