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Trauma Patients: A Case Study

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Introduction: The prevalence of marijuana abuse and dependence has been increasing among adults and adolescents trauma patients in the United States. Several studies have demonstrated effects of marijuana on the outcomes of diseases. The aim of this study was to assess the relationship between the presence of a positive toxicology screen for marijuana and mortality in trauma patients. Methods: We performed a 5-year (2008-2012) retrospective analysis of adult trauma patients (>18 y/o) using the Arizona State Trauma database. We included patients admitted to the ICU with a positive toxicology screen for marijuana. We excluded patients with positive alcohol or other substance screening. Patient demographics, injury and vital parameters, and toxicology data were collected. Our outcome measures were mortality, ventilator days, ICU and hospital Length of Stay (LOS). We matched …show more content…

Rate of positive screening for marijuana was 7.4 % (2127/28813) in trauma population. Mean age was 31 ± 9, 82.8% were male, and median ISS [IQR] was 13[8-20]. There was no difference in median hospital (6.4d vs. 5.4d, p=0.08) or median ICU (3d vs. 4d, p=0.43) LOS between the two groups. 55.3% (740/1339) of the marijuana positive patients received mechanical ventilation as compared to 32% (428/1339) of marijuana negative patients (p< 0.001). On sub analysis of patients who received mechanical ventilation, marijuana positive patients had higher median ventilator days (2d vs. 1d, p=0.02), and a lower mortality rate (7.3% vs. 16.1%, p<0.001) compared to patients who were negative for marijuana on toxicology screening. 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

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