Marijuana may lead to increased platelet activity in trauma patients.

INTRODUCTION

Delta-9-tetraydrocannabinol (THC) usage is associated with venous thromboembolic events (VTE) in trauma patients. We hypothesized that THC ​+ ​trauma patients would have less platelet inhibition than THC - patients using thromboelastography with platelet mapping (TEG-PM).

METHODS

Results from initial TEG- PM assays and patient's UDS were reviewed between 2019 and 2023. Mean levels of arachidonic acid (AA) and adenosine diphosphate (ADP) percent inhibition were compared by THC status.

RESULTS

793 patients had TEG-PM and UDS data. Mean levels of arachidonic acid (AA) percentage inhibition were 32.6 ​± ​34.2. AA inhibition was lower for THC ​+ ​vs THC- patients (THC+ 23.9 ​± ​27.0 vs THC- 34.3 ​± ​35.3, P ​< ​0.001). There was no association between THC status and ADP inhibition (THC+ 32.5 ​± ​27.1 vs THC- 30.8 ​± ​28.4, P ​= ​0.536).

DISCUSSION: To our knowledge, our data are the first to suggest a clinically measurable increase in platelet reactivity in THC ​+ ​trauma patients. More work is needed to determine if addition of aspirin to the chemoprophylaxis strategy for THC ​+ ​patients would mitigate the known association of THC with VTE.