Cannabis Use and Its Association With Complications and Outcomes in Burn Patients: Insights From the National Trauma Data Bank

Cannabis use has increased with expanding legalization and societal acceptance, raising questions about its impact on burn care. Given its known effects on pain perception, metabolism, and immune modulation, cannabis may influence various aspects of burn treatment, including pain management, wound healing, and rates of infection. This study explores trends in cannabis use among burn patients and evaluates its association with clinical outcomes using the National Trauma Data Bank (NTDB). The NTDB was used to identify burn patients from 2017 to 2021, isolating burn injuries through e-code variables. Cannabis use was documented at admission, and patients without screening data were excluded. The primary exposure variable was cannabis use, with outcomes including mortality, stroke, myocardial infarction, organ failure, timing of surgery, and postsurgical complications. Secondary outcomes included ED vital signs, length of stay, and intensive care needs. Multivariable regression models were applied to analyze the association between cannabis use and outcomes. Of 319 941 burn patients, 52 803 (16.5%) tested positive for cannabis. Cannabis-positive patients were more likely to be male (18% vs 11%, P < .001) and younger (28.9 vs 32.6 years, P < .001). They had higher rates of venothromboembolic events, required longer ICU stays, and were more likely to develop ventilator-associated pneumonia. Additionally, cannabis-positive patients had a higher incidence of organ failure (2.1% vs 1.3%, P = .012) and reoperations (5.2% vs 4.1%, P = .019). Cannabis use in burn patients is associated with more complex recoveries, including higher risks of complications. Integrating cannabis screening into burn care protocols and further research is essential to optimize treatment strategies.