Research Reports - Effect of marijuana use on outcomes in traumatic brain injury
Am Surg. 2014 Oct;80(10):979-83
Nguyen BM(1), Kim D, Bricker S, Bongard F, Neville A, Putnam B, Smith J, Plurad D
Traumatic brain injury (TBI) is associated with significant morbidity and
mortality. Several studies have demonstrated neuroprotective effects of
cannabinoids. The objective of this study was to establish a relationship between
the presence of a positive toxicology screen for tetrahydrocannabinol (THC) and
mortality after TBI. A 3-year retrospective review of registry data at a Level I
center of patients sustaining TBI having a toxicology screen was performed.
Pediatric patients (younger than 15 years) and patients with a suspected
nonsurvivable injury were excluded. The THC(+) group was compared with the THC(-)
group with respect to injury mechanism, severity, disposition, and mortality.
Logistic regression was used to determine independent associations with
mortality. There were 446 cases meeting all inclusion criteria. The incidence of
a positive THC screen was 18.4 per cent (82). Overall mortality was 9.9 per cent
(44); however, mortality in the THC(+) group (2.4% [two]) was significantly
decreased compared with the THC(-) group (11.5% ; P = 0.012). After adjusting
for differences between the study cohorts on logistic regression, a THC(+) screen
was independently associated with survival after TBI (odds ratio, 0.224; 95%
confidence interval, 0.051 to 0.991; P = 0.049). A positive THC screen is
associated with decreased mortality in adult patients sustaining TBI.