Changes in Emergency Department Encounters for Vomiting After Cannabis Legalization in Colorado.
Changes in Emergency Department Encounters for Vomiting After Cannabis Legalization in Colorado.
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DOI：
10.1001/jamanetworkopen.2021.25063
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发表时间：
2021-09-01
影响因子：
13.8
通讯作者：
Pacula RL
中科院分区：
文献类型：
--
作者：
Wang GS;Buttorff C;Wilks A;Schwam D;Tung G;Pacula RL
科罗拉多州休闲大麻合法化后，与呕吐相关的急诊就诊人数是否有所增加？在这项对 820-778 名通过科罗拉多州急诊科寻求治疗的患者进行的横断面研究中，大麻合法化与每年呕吐相关医疗事件的增加有关。在没有现有医疗药房的县中观察到增幅最高。这些发现表明，大麻合法化州的医疗保健临床医生应该了解与大麻剧吐综合征相关的症状；记录可能有助于确保对大麻合法化相关后果进行准确的公共卫生监测。大麻剧吐综合征是一个与大麻使用相关的新出现的临床问题。大麻合法化导致医疗机构中呕吐相关疾病的增加。研究科罗拉多州大麻合法化是否与呕吐相关急诊室 (ED) 就诊人数增加有关。采用横断面设计来评估 2013 年 1 月 1 日至 2018 年 12 月 31 日期间向科罗拉多医院协会报告的急诊室呕吐索赔的增加情况，这些县在合法化之前没有大麻药房，与有大麻药房的县相比。分析中纳入了总共 820–778 名通过科罗拉多州急诊室寻求护理的患者。每季度每个县的医疗和娱乐大麻药房数量。每季度县人均呕吐相关急诊索赔率。与呕吐相关的急诊科就诊次数从 2013 年的 119 312 例增加到 2018 年的 153 699 例（增加了 29%）。在此期间，203 861 名患者（25%）年龄在 0 至 18 岁之间； 114 201 人（14%）年龄在 19 至 25 岁之间，502 771 人（61%）年龄在 26 岁或以上； 510 584 名患者 (62%) 为女性。额外的娱乐药房与呕吐相关的急诊就诊次数增加有关（发生率比，1.03；95% CI，1.01-1.05），但与没有基线医疗药房暴露的县相比，具有高基线医疗药房暴露的县与呕吐相关的急诊就诊次数增加幅度较小（发生率比，0.97；95% CI，0.95-0.99）。拥有大量医用大麻药房的县的增长速度比没有医用大麻药房的县慢 5.8%。这项研究的结果表明，科罗拉多州的大麻合法化与每年接触这些市场的呕吐相关医疗事件的增加有关。对于卫生保健临床医生来说，了解大麻剧吐综合症并在适当的时候询问大麻的使用情况可能会很有用。这项横断面研究调查了自科罗拉多州大麻合法化以来因大麻相关呕吐的个人到急诊室就诊的比率的变化。
Has the number of vomiting-related emergency department visits increased after recreational cannabis legalization in Colorado? In this cross-sectional study of 820 778 patients seeking care through Colorado emergency departments, cannabis legalization was associated with an increase in annual vomiting-related health care encounters. The highest increases were observed in counties without existing medical dispensaries. These findings suggest that health care clinicians in states that have legalized cannabis should be aware of symptoms associated with cannabis hyperemesis syndrome; documentation may help ensure accurate public health surveillance on consequences associated with cannabis legalization. Cannabis hyperemesis syndrome is an emerging clinical issue associated with cannabis use. Legalization of cannabis has led to an increase in vomiting-related illnesses in health care settings. To examine whether legalization of cannabis in Colorado has been associated with increases in vomiting-related emergency department (ED) visits. A cross-sectional design was used to assess the increase in ED claims for vomiting reported to the Colorado Hospital Association between January 1, 2013, and December 31, 2018, in counties that had no prior cannabis dispensaries before legalization compared with those that did. A total of 820 778 patients seeking care through Colorado EDs were included in the analysis. The number of medical and recreational cannabis dispensaries per county per quarter. County per capita rate of vomiting-related ED claims per quarter. Vomiting-related ED health care encounters increased from 119 312 in 2013 to 153 699 in 2018 (29% increase). Over this period, 203 861 patients (25%) were aged 0 to 18 years; 114 201 (14%) were aged 19 to 25 years, and 502 771 (61%) were aged 26 years or older; 510 584 patients (62%) were female. Additional recreational dispensaries were associated with increased vomiting-related ED visits (incidence rate ratio, 1.03; 95% CI, 1.01-1.05), but counties with high baseline medical dispensary exposure experienced smaller increases in vomiting-related ED visits than counties with no baseline medical dispensary exposure (incidence rate ratio, 0.97; 95% CI, 0.95-0.99). Counties with a high number of medical marijuana dispensaries had increases at a 5.8% slower rate than counties with none. The findings of this study suggest that cannabis legalization in Colorado is associated with an increase in annual vomiting-related health care encounters with regard to exposure to these markets. It may be useful for health care clinicians to be aware of cannabis hyperemesis syndrome and inquire about cannabis use when appropriate. This cross-sectional study examines changes in the rates of emergency department presentation by individuals with cannabis-related vomiting since legalization of cannabis in Colorado.
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