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Tytuł:
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Preinjury Use of Marijuana and Outcomes in Trauma Patients.
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Autorzy:
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Taghavi S; Department of Surgery, Division of Trauma & Critical Care, Tulane University School of Medicine, New Orleans, Louisiana.
Ramirez S; Trauma Specialist Program, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana; Dartmouth College Geisel School of Medicine, Hanover, New Hampshire.
Duchesne J; Department of Surgery, Division of Trauma & Critical Care, Tulane University School of Medicine, New Orleans, Louisiana.
Tatum D; Trauma Specialist Program, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana. Electronic address: .
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Źródło:
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The Journal of surgical research [J Surg Res] 2021 Jan; Vol. 257, pp. 42-49. Date of Electronic Publication: 2020 Aug 17.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: New York, NY : Academic Press
Original Publication: Philadelphia [etc.]
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MeSH Terms:
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Marijuana Use*
Wounds and Injuries/*therapy
Adult ; Brain Injuries, Traumatic ; Critical Care ; Dronabinol/analysis ; Female ; Humans ; Injury Severity Score ; Male ; Odds Ratio ; Trauma Centers ; Treatment Outcome ; Wounds and Injuries/mortality ; Wounds, Penetrating/mortality ; Wounds, Penetrating/therapy
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Contributed Indexing:
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Keywords: Endocannabinoid; Marijuana; Outcomes; Tetrahydrocannabinol; Trauma
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Substance Nomenclature:
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7J8897W37S (Dronabinol)
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Entry Date(s):
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Date Created: 20200821 Date Completed: 20201231 Latest Revision: 20201231
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Update Code:
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20240105
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DOI:
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10.1016/j.jss.2020.07.011
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PMID:
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32818783
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Background: Recent studies have examined the effects of marijuana in various populations; however, there has been limited research on the effect of marijuana use in severely injured trauma patients. We hypothesized that preinjury use of marijuana would be associated with improved outcomes in severely injured trauma patients.
Methods: All adult (18+ y) level I and level II trauma activations who presented to two large regional trauma centers between 2014 and 2018 were reviewed. Delta-9-tetrahydrocannabinol (THC)- indicated absence of drugs confirmed by testing and as THC + confirmed THC without another drug present.
Results: Of the 4849 patients included, 1373 (28.3%) were THC+. The THC + cohort was younger, had more males, and was more likely to be injured by penetrating mechanism (P < 0.001 for all) than THC-. THC + patients had shorter median length of stay (LOS) (P < 0.001) and intensive care unit LOS (P < 0.001). Mortality rate was lower in the THC + group (4.3% versus 7.6%, P < 0.001), but not in multivariate analysis. THC + patients with traumatic brain injury had shorter hospital LOS (P = 0.025) and shorter ventilator days (P = 0.033) than THC- patients. In patients with Injury Severity Score ≥16, THC + patients had significantly lower intensive care unit LOS (P = 0.009) and mortality (19.3% versus 25.0% P = 0.038) than drug-negative patients.
Conclusions: Although preinjury use of marijuana does not improve survival in trauma patients, it may provide some improvement in outcomes in patients with traumatic brain injury and those that are more severely injured (Injury Severity Score ≥16). The mechanism behind this finding needs further evaluation.
(Copyright © 2020 Elsevier Inc. All rights reserved.)