Cannabis Use Disorder Linked to Longer ICU Stays but Not Higher Death Rates in Australian Hospitals | Research

The takeaway

Among 34,680 ICU admissions across four Australian hospitals, 0.8% had a cannabis use disorder diagnosis, and these patients had longer ICU stays but similar mortality rates after adjusting for age and illness severity.

Intensivists, critical care nurses, hospital administrators, addiction medicine specialists

Double the ICU length of stay despite younger age and fewer comorbidities

What the researchers found

Of 34,680 ICU admissions, 292 (0.8%) had cannabis-related diagnoses. Cannabis-associated patients were younger (36 vs 62 years), more often male (73%), with fewer comorbidities. ICU LOS was longer (2 vs 1 days, p < 0.0001). After adjusting for age, severity, and comorbidities, the mortality difference disappeared (p = 1.0).

Why it matters

The finding that cannabis-associated patients stay longer in the ICU despite being younger and less comorbid suggests cannabis may complicate critical care management in ways not captured by standard severity scores.

The numbers in context

34,680 admissions; 292 (0.8%) cannabis-related; median age 36 vs 62; 73% male; ICU LOS 2 vs 1 days (p < 0.0001); no mortality difference after adjustment.

How the study worked

Retrospective cohort analysis of 34,680 admissions among 28,689 adults at four public Australian ICUs. Cannabis use identified by ICD10-AM diagnostic codes.

What this study cannot tell us

ICD-10 coding likely underidentifies cannabis users. Cannot determine whether cannabis directly caused longer stays. Four Australian ICUs may not represent other settings.

How to read the evidence

Multi-center retrospective cohort with appropriate adjustment, limited by ICD-code identification.

When this study was published

2024 publication

The bigger picture

The longer ICU stay without increased mortality suggests cannabis-related complications extend recovery without worsening ultimate outcomes.

Questions still open

What specific factors drive the longer ICU stays in cannabis-associated patients?
Does cannabis withdrawal contribute to prolonged ICU care?

Common questions

Does cannabis affect ICU outcomes?

In this study of 34,680 ICU admissions, cannabis-associated patients stayed twice as long (2 vs 1 day) despite being younger with fewer health problems. Mortality rates were the same after adjustment.

How common is cannabis use among ICU patients?

Only 0.8% had documented cannabis-related diagnoses, though the actual rate is likely higher. These patients were predominantly younger men (median age 36, 73% male).

Read the original research

Cannabis use disorders and outcome of admission to intensive care: A retrospective multi-centre cohort study.

Journal of critical care, 80, 154504

View on PubMed ↗Publisher’s paper ↗

Citation

Renger, Laura; Dhanani, Jayesh; Milford, Elissa; Tabah, Alexis; Shekar, Kiran; Ramanan, Mahesh; Laupland, Kevin B. (2024). Cannabis use disorders and outcome of admission to intensive care: A retrospective multi-centre cohort study.. Journal of critical care, 80, 154504. https://doi.org/10.1016/j.jcrc.2023.154504