WIP 40 - Treatment Modalities and Outcomes of Cannabinoid Hyperemesis Syndrome at Oklahoma Children’s: A Retrospective Analysis

Publication Number: WIP 40.7477

Saleena Ramzanali, University of Oklahoma College of Medicine, Oklahoma City, OK, United States; Christina Harris, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States; Stephanie DeLeon, University of Oklahoma Health Sciences Center, Norman, OK, United States; Peace A. Okpoko, University of Oklahoma College of Medicine, Oklahoma City, OK, United States

Background: In 2018, Oklahoma legalized the usage of medical marijuana; this has been associated with an increase in THC toxicity-related pediatric presentations in our state. Cannabinoid Hyperemesis Syndrome (CHS) is characterized by intractable vomiting and abdominal pain in chronic cannabis users. CHS poses significant challenges for both the patients and healthcare providers and may lead to recurrent Emergency Department (ED) visits, hospitalizations, and unnecessary workups. Most studies done on CHS have been done in the adult population and focus on successful treatments rather than ineffective therapies. Symptoms are often refractory to various antiemetics, and permanent relief is ultimately achieved by complete cessation of cannabis use.

Objective: This study aims to describe current trends in presentations for CHS, including patient demographic and marijuana usage information, and analyze the effects of various pharmacologic and non-pharmacologic treatment modalities on length of stay (LOS), rates of admission from the ED, and need for supplemental nutrition. Findings will contribute to the understanding of CHS management practices and can be used to develop more effective treatment protocols.

Design/Methods: A retrospective analysis is underway on patients aged 12-18 years of age who present to OU Health emergency departments, inpatient services, and pediatric intensive care units from January 2019 – December 2024. Cases were initially identified using ICD 10 codes related to CHS or THC use/abuse coded with abdominal pain and/or vomiting. Manual chart review and discussion by study investigators will ensure complete data collection and accuracy of coding. Demographics, duration and frequency of cannabis use, visit dates, treatment modalities, need for supplemental nutrition, and need for IV rehydration were collected. The main comparative data of interest will be the treatment modalities and length of stay for patients with CHS.