Abstract
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. © 2024 Elsevier Inc.