Department of Pediatrics, Section of Pediatric Emergency Medicine.
Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Pediatrics. 2024 Jun 1;153(6). doi: 10.1542/peds.2024-065881.
In conjunction with widening legalization, there has been a rapid rise in unintentional cannabis ingestions in young children. We sought to determine if the legal status of recreational cannabis was associated with resource use in young children with cannabis poisoning.
This retrospective cross-sectional study of the Pediatric Health Information System included emergency department encounters between January 2016 and April 2023 for children <6 years of age with a diagnosis indicating cannabis ingestion. The primary exposure was recreational cannabis legalization status in the state in which the encounter occurred. We used logistic regression models to determine the association of recreational cannabis legality with resource utilization outcomes, adjusting for demographic covariates.
We included 3649 children from 47 hospitals; 29% of encounters occurred in places in which recreational cannabis was legal. Compared with environments in which recreational cannabis was illegal, cannabis-legal locations had lower uses of advanced neuroimaging (24% vs 35%; adjusted odds ratio [aOR], 0.65; 95% confidence interval [CI]: 0.55-0.77), lumbar puncture (1.6% vs 3.8%; aOR, 0.42; 95% CI: 0.24-0.70), ICU admission (7.9% vs 11%; aOR, 0.71; 95% CI: 0.54-0.93), and mechanical ventilation (0.8% vs 2.9%; aOR, 0.30; 95% CI: 0.14-0.58). Urine testing was more common in places in which recreational cannabis was legal (71% vs 58%; aOR, 1.87; 95% CI: 1.59-2.20).
State-level legalization of recreational cannabis was associated with a significant decrease in the utilization of advanced medical resources in cases of cannabis intoxication in children. These findings suggest the need for a focus on policies and procedures to minimize invasive testing in cases of cannabis intoxication in children.
随着大麻合法化范围的扩大，儿童误食大麻的情况迅速增加。我们旨在确定娱乐性大麻的合法地位是否与大麻中毒儿童的资源利用有关。
这项回顾性的病例交叉研究利用了儿科健康信息系统，纳入了 2016 年 1 月至 2023 年 4 月期间 6 岁以下儿童因摄入大麻而就诊的急诊病例。主要暴露因素是发生就诊的州的娱乐性大麻合法化状态。我们使用逻辑回归模型来确定娱乐性大麻合法化与资源利用结果之间的关联，并根据人口统计学协变量进行调整。
我们纳入了来自 47 家医院的 3649 名儿童；29%的就诊发生在娱乐性大麻合法的地区。与娱乐性大麻非法的地区相比，大麻合法地区的高级神经影像学检查使用率较低（24%对 35%；调整后的优势比[OR]，0.65；95%置信区间[CI]：0.55-0.77）、腰椎穿刺术（1.6%对 3.8%；OR，0.42；95%CI：0.24-0.70）、重症监护病房（ICU）入院（7.9%对 11%；OR，0.71；95%CI：0.54-0.93）和机械通气（0.8%对 2.9%；OR，0.30；95%CI：0.14-0.58）。尿液检测在娱乐性大麻合法的地区更为常见（71%对 58%；OR，1.87；95%CI：1.59-2.20）。
州级娱乐性大麻合法化与儿童大麻中毒病例中高级医疗资源利用率的显著下降有关。这些发现表明，需要关注政策和程序，以尽量减少儿童大麻中毒病例中的侵入性检测。
