Grand Ouest Poison Control and Toxicovigilance Center, Angers University Hospital, Angers, France.
Poison Control and Toxicovigilance Center, Bordeaux University Hospital, Bordeaux, France.
Clin Toxicol (Phila). 2021 Apr;59(4):326-333. doi: 10.1080/15563650.2020.1806295. Epub 2020 Aug 25.
Accidental pediatric cannabis poisonings are an incidental effect of cannabis use. The average THC content of cannabis resin and the number of consumers are rising sharply in the USA and in most European countries. The objective is to study the evolution of prevalence and severity of pediatric exposures to cannabis in France.
This is a retrospective observational study of cases detected by French poison centers between January 1 2010 and December 31 2017 of cannabis exposure by ingestion in children aged ten or younger. The clinical severity was assessed using the Poisoning Severity Score (PSS). The criteria used for assessing the overall severity were as follows: PSS ≥ 2, admission to pediatric intensive care, coma and respiratory depression (univariate and multivariate logistic regression).
A total of 965 cases of poisoning were covered. The annual average number of cases was 93 between 2010 and 2014 and 167 between 2015 and 2017. The median age was 15 months (range, 6 months-10 years) and the sex ratio was 1:1. The form of cannabis ingested was mainly resin (75%). During the period covered by the study, 26.1% of children ( = 252) presented with a PSS ≥ 2, 4.5% ( = 43) coma, 4.6% ( = 44) with respiratory depression and 11.7% ( = 113) were admitted into pediatric intensive care (out of 819 hospitalizations). No fatal cases were reported. In comparison to the 2010-2014 period, the length of hospital stays was significantly higher ( < 0.0001) and the comas were significantly deeper (lower score on the Glasgow coma scale, < 0.005) in 2015-2017. Following adjustments made for the sex, age and weight of the children, the data show that the severity of the poisonings was significantly greater in 2015-2017 in terms of PSS score, the number of comas and monitoring in intensive care ( < 0.001).
The data indicates a significant increase in the number of cases of pediatric exposure to cannabis and a rise in the seriousness of poisonings between 2010 and 2017.
儿童意外摄入大麻中毒是大麻使用的附带后果。在美国和大多数欧洲国家，大麻树脂的平均四氢大麻酚含量和消费者数量都在急剧上升。本研究旨在研究法国儿童摄入大麻中毒的流行率和严重程度的变化。
这是一项回顾性观察性研究，研究对象为 2010 年 1 月 1 日至 2017 年 12 月 31 日期间，10 岁以下儿童因摄入大麻而被法国中毒中心检测到的病例。使用中毒严重程度评分（PSS）评估临床严重程度。用于评估整体严重程度的标准如下：PSS≥2，入住儿科重症监护病房，昏迷和呼吸抑制（单变量和多变量逻辑回归）。
共纳入 965 例中毒病例。2010 年至 2014 年期间，年平均病例数为 93 例，2015 年至 2017 年期间为 167 例。中位年龄为 15 个月（范围为 6 个月至 10 岁），性别比为 1:1。摄入的大麻形式主要为树脂（75%）。在研究期间，26.1%的儿童（=252 例）的 PSS≥2，4.5%（=43 例）出现昏迷，4.6%（=44 例）出现呼吸抑制，11.7%（=113 例）入住儿科重症监护病房（819 例住院患儿）。未报告死亡病例。与 2010-2014 年相比，2015-2017 年住院时间明显延长（P<0.0001），格拉斯哥昏迷评分较低（P<0.005），昏迷程度更深。在调整了儿童的性别、年龄和体重后，数据显示，2015-2017 年 PSS 评分、昏迷和重症监护监测的中毒严重程度明显更高（P<0.001）。
数据表明，2010 年至 2017 年期间，儿童摄入大麻中毒的病例数显著增加，中毒严重程度也有所上升。
