Combined Impact of Cannabinoids and Cocaine on Outcomes of Trauma Patients

In recent years, the use of polypharmacy has surged. There is a gap in knowledge regarding the impact of pre-injury use of polypharmacy on outcomes. The purpose of the study was to evaluate the effects of cannabinoids (CANB) and cocaine (COC) on trauma patients' outcomes. The hypothesis is, no difference in-hospital mortality in patients who tested positive for CANB+COC versus those who only tested positive for CANB.

The Trauma Quality Improvement Program (TQIP) for 2019-2023 dataset was used. Patients' demography, clinical characteristics, injury type and severity, and outcomes were compared between patients who tested positive for CANB+COC and those who tested positive only for CANB. Propensity score matching methodology was used to obtain the results. A p-value < 0.05 was considered statistically significant.

Out of 120,951 patients who qualified for the study, 12,116 pairs of patients were obtained from the propensity score matching process. Most of the baseline characteristics of the two groups, CANB+COC versus CANB, had no significant difference in age (years) (median [IQR]: 37 [28 - 51] vs. 32 [23 - 51]) or sex (male: 81% vs. 76.6%), ISS score (median [IQR]: 9 [5 - 17] vs. 10 [5 - 17]. Pair-matched analysis showed no significant difference in in-hospital mortality (2.2% vs. 2.2%, P = 0.86) but it showed a longer hospital length of stay (5 [5, 5] vs. 4 [4, 4], P < 0.0001), a higher event of unplanned intubation (1.5% versus 1%, P = 0.002) and a higher occurrence of ventilator associated pneumonia (1% versus 0.7%, P = 0.01) in patients who tested positive for CANB+COC versus CANB.

No significant association was observed between the in-hospital mortality and combined use of, CANB+COC when compared to only CANB use. However, combined drug usage was associated with a longer length of hospital stay.