Marijuana and thromboembolic events in geriatric trauma patients: The cannabinoids clots correlation

Science Direct- The American Journal of Surgery Volume 223, Issue 4, April 2022, Pages 798-803
2022
Samer Asmar, Adam Nelson, Tanya Anand, Ahmad Hammad, Omar Obaid, Michael Ditillo, Tawab Saljuqi, Andrew Tang, Bellal Joseph

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Abstract

Background

Tetrahydrocannabinol (THC) can alter the coagulation cascade resulting in hypercoagulability. The aim of our study is to evaluate the impact of THC use on thromboembolic complications (TEC) in geriatric trauma patients (GTP).

Methods

This is a 2017 analysis of the TQIP database including all GTP (age ≥65 years). Patients were stratified based on THC use. Propensity score matching (1:2 ratio) was performed.

Results

A total of 2,835 patients were matched (THC+: 945 and THC-: 1,890). Mean age was 70 ± 6 years, 94% sustained blunt injuries, and median ISS was 22[12–27]. Sixty-two percent of patients received thromboprophylaxis, with median time to initiation of 27 h from admission. Overall, the rate of TEC was 2.1% and mortality was 6.0%. THC + patients had significantly higher rates of TEC compared to THC- patients (3.0% vs. 1.7%; p = 0.01). Rates of DVT (2.2% vs 0.6%, p < 0.01) and PE (1.4% vs 0.4%, p < 0.01) were higher in the THC + group.

Conclusion

THC exposure increases the risk of TEC in GTP. Incorporation of THC use into risk assessment protocols merits serious consideration in GTP.

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