Acute Illness Associated With Cannabis Use, by Route of Exposure An Observational Study
Acute Illness Associated With Cannabis Use, by Route of Exposure An Observational Study
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DOI：
10.7326/m18-2809
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发表时间：
2019-04-16
影响因子：
39.2
通讯作者：
Abbott, Diana
中科院分区：
文献类型：
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作者：
Monte, Andrew A.;Shelton, Shelby K.;Abbott, Diana
背景：关于可食用和可吸入大麻制品的相对危害知之甚少。
目的：描述并比较与食用和吸入大麻暴露相关的成人急诊科（ED）就诊情况。
设计：对2012年1月1日至2016年12月31日期间急诊科就诊情况进行病历回顾。
地点：科罗拉多州一家大型城市学术医院。
参与者：因大麻相关疾病（依据国际疾病分类第九版或第十版临床修订本（ICD - 9 - CM或ICD - 10 - CM）编码）就诊于急诊科的成人。
测量指标：患者人口统计学特征、暴露途径、剂量、症状、住院时间、处置情况、出院诊断以及就诊与大麻的关联。
结果：共有9973次就诊使用了大麻的ICD - 9 - CM或ICD - 10 - CM编码。其中，2567次（25.7%）就诊至少部分归因于大麻，其中238次（9.3%）与食用大麻有关。归因于吸入大麻的就诊更可能是因为大麻素呕吐综合征（18.0%对8.4%），而归因于食用大麻的就诊更可能是由于急性精神症状（18.0%对10.9%）、中毒（48%对28%）和心血管症状（8.0%对3.1%）。2014年至2016年期间，可食用制品在归因于大麻的就诊中占10.7%，但在此期间在科罗拉多州仅占大麻总销售额（以四氢大麻酚千克数计）的0.32%。
局限性：回顾性研究设计、单一学术中心、自我报告的暴露数据以及剂量数据有限。
结论：归因于吸入大麻的就诊比归因于食用大麻的就诊更频繁，尽管后者与更多的急性精神科就诊以及比预期更多的急诊科就诊相关。
Background: Little is known about the relative harms of edible and inhalable cannabis products.Objective: To describe and compare adult emergency department (ED) visits related to edible and inhaled cannabis exposure.Design: Chart review of ED visits between 1 January 2012 and 31 December 2016.Setting: A large urban academic hospital in Colorado.Participants: Adults with ED visits with a cannabis-related International Classification of Diseases, Ninth or 10th Revision, Clinical Modification (ICD-9-CM or ICD-10-CM), code.Measurements: Patient demographic characteristics, route of exposure, dose, symptoms, length of stay, disposition, discharge diagnoses, and attribution of visit to cannabis.Results: There were 9973 visits with an ICD-9-CM or ICD-10-CM code for cannabis use. Of these, 2567 (25.7%) visits were at least partially attributable to cannabis, and 238 of those (9.3%) were related to edible cannabis. Visits attributable to inhaled cannabis were more likely to be for cannabinoid hyperemesis syndrome (18.0% vs. 8.4%), and visits attributable to edible cannabis were more likely to be due to acute psychiatric symptoms (18.0% vs. 10.9%), intoxication (48% vs. 28%), and cardiovascular symptoms (8.0% vs. 3.1%). Edible products accounted for 10.7% of cannabis-attributable visits between 2014 and 2016 but represented only 0.32% of total cannabis sales in Colorado (in kilograms of tetrahydrocannabinol) during that period.Limitation: Retrospective study design, single academic center, self-reported exposure data, and limited availability of dose data.Conclusion: Visits attributable to inhaled cannabis are more frequent than those attributable to edible cannabis, although the latter is associated with more acute psychiatric visits and more ED visits than expected.