Bennett Colleen E, Venkataramani Atheendar, Henretig Fred M, Faerber Jennifer, Song Lihai, Wood Joanne N
Division of General Pediatrics, The Children's Hospital of Philadelphia (CE Bennett and JN Wood), Philadelphia, Pa; National Clinician Scholars Program, University of Pennsylvania (CE Bennett, A Venkataramani, and JN Wood), Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania (CE Bennett, FM Henretig, and JN Wood), Philadelphia, Pa.
National Clinician Scholars Program, University of Pennsylvania (CE Bennett, A Venkataramani, and JN Wood), Philadelphia, Pa; Leonard Davis Institute of Health Economics, University of Pennsylvania, Colonial Penn Center (A Venkataramani, FM Henretig, and JN Wood), Philadelphia, Pa; Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania (A Venkataramani), Philadelphia, Pa.
Acad Pediatr. 2022 May-Jun;22(4):592-597. doi: 10.1016/j.acap.2021.07.018. Epub 2021 Jul 26.
Multiple states have passed legislation permitting marijuana use. The impact of legalization on trends in hospital encounters for marijuana exposures in young children across states remains unknown. We aimed to describe trends in marijuana-related hospital encounters over time in children <6 years and assess the association of state-level marijuana legislation with the rate of marijuana-related hospitalizations.
We identified inpatient, emergency department and observation encounters for children <6 years with marijuana exposures (defined by International Classification of Diseases diagnosis codes) unique on the patient-year level at 52 children's hospitals in the Pediatric Health Information System database from 01/01/2004 to 12/31/2018. Trends in encounters across the study period were evaluated using negative binomial regression with outcome of marijuana-related hospital encounters and year as the predictor variable accounting for clustering by hospital. We then estimated a negative binomial regression difference-in-difference model to examine the association between the main outcome and state recreational and medical marijuana legalization.
Of the 1296 included unique patient-year encounters, 50% were female with mean age 2.1 years (standard deviation = 1.4). Fifty percent were inpatient (n = 645) and 15% required intensive care with 4% requiring mechanical ventilation. There was a 13.3-fold increase in exposures in 2018 compared to 2004 (P< .001). We did not find an effect of state legalization status for recreational (P = .24) or medical (P = .30) marijuana.
The observed dramatic increase in marijuana-related hospital encounters highlights the need for prevention strategies aimed at reducing unintentional marijuana exposures in young children, even in states without legislation permitting marijuana use.
多个州已通过允许使用大麻的立法。大麻合法化对各州幼儿因接触大麻而就医趋势的影响尚不清楚。我们旨在描述6岁以下儿童与大麻相关的就医趋势，并评估州级大麻立法与大麻相关住院率之间的关联。
我们在儿科健康信息系统数据库中，识别了2004年1月1日至2018年12月31日期间52家儿童医院中6岁以下儿童因接触大麻（由国际疾病分类诊断代码定义）而产生的住院、急诊科和观察就诊情况，这些情况在患者年份层面是唯一的。使用负二项回归评估研究期间的就诊趋势，以与大麻相关的就医情况为结果变量，年份为预测变量，并考虑医院聚类情况。然后，我们估计了一个负二项回归差异模型，以检验主要结果与州级娱乐用大麻和医用大麻合法化之间的关联。
在纳入的1296次独特的患者年份就诊中，50%为女性，平均年龄2.1岁（标准差 = 1.4）。50%为住院患者（n = 645），15%需要重症监护，4%需要机械通气。与2004年相比，2018年的接触次数增加了13.3倍（P < .001）。我们没有发现州级娱乐用大麻（P = .24）或医用大麻（P = .30）合法化的影响。
观察到的与大麻相关的就医情况急剧增加，凸显了制定预防策略以减少幼儿意外接触大麻的必要性，即使在没有允许使用大麻立法的州也是如此。
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