A Grigorian1, E Lester2, M Lekawa2, C Figueroa2, C M Kuza3, M Dolich2, S D Schubl2, C Barrios2, J Nahmias2. 1. University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA. Electronic address: agrigori@uci.edu. 2. University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA. 3. University of Southern California, Department of Anesthesia, Los Angeles, CA, USA.
Abstract
BACKGROUND: Marijuana has become legal in eight states since 2012. We hypothesized the incidence of marijuana-positive trauma patients and rate of mortality has increased post-legalization. METHODS: A single level-I trauma center was used to identify patients screening positive for marijuana on urine-toxicology. Patients in the pre-legalization and post-legalization periods were compared. RESULTS: In the pre-legalization cohort 9.4% were marijuana-positive versus 11.0% in the post-legalization cohort (p = 0.001). Marijuana-positive patients post-legalization had higher rates of critical trauma activation (20.0% vs. 15.0%, p = 0.01) and mortality (2.6% vs. 1.2%, p = 0.03). In the pediatric (age 12-17) subgroup, the incidence of marijuana-positive patients did not change after legalization (pre: 39.3%, post: 46.4%, p = 0.24). CONCLUSION: The incidence of marijuana-positive trauma patients increased post-legalization. Adult marijuana-positive trauma patients post-legalization were more likely to meet criteria for critical trauma activation and have a higher mortality rate. A subgroup of pediatric patients had an alarmingly high rate of marijuana use. SUMMARY: The rate of marijuana use among trauma patients increased post-legalization in California. The rate of critical trauma activation also increased as well as the mortality rate.
BACKGROUND:Marijuana has become legal in eight states since 2012. We hypothesized the incidence of marijuana-positive traumapatients and rate of mortality has increased post-legalization. METHODS: A single level-I trauma center was used to identify patients screening positive for marijuana on urine-toxicology. Patients in the pre-legalization and post-legalization periods were compared. RESULTS: In the pre-legalization cohort 9.4% were marijuana-positive versus 11.0% in the post-legalization cohort (p = 0.001). Marijuana-positive patients post-legalization had higher rates of critical trauma activation (20.0% vs. 15.0%, p = 0.01) and mortality (2.6% vs. 1.2%, p = 0.03). In the pediatric (age 12-17) subgroup, the incidence of marijuana-positive patients did not change after legalization (pre: 39.3%, post: 46.4%, p = 0.24). CONCLUSION: The incidence of marijuana-positive traumapatients increased post-legalization. Adult marijuana-positive traumapatients post-legalization were more likely to meet criteria for critical trauma activation and have a higher mortality rate. A subgroup of pediatric patients had an alarmingly high rate of marijuana use. SUMMARY: The rate of marijuana use among traumapatients increased post-legalization in California. The rate of critical trauma activation also increased as well as the mortality rate.
Authors: Nicole V Tolan; Tolumofe Terebo; Peter R Chai; Timothy B Erickson; Bryan D Hayes; Sacha N Uljon; Athena K Petrides; Christiana A Demetriou; Stacy E F Melanson Journal: Clin Toxicol (Phila) Date: 2021-12-22 Impact factor: 4.467