Resident The University of South Florida Saint Petersburg, Florida, United States
Background: The steady rise in cannabis uses among adolescents as directly influenced the emergence, discussion, and awareness of a cohort of patients presenting with cannabinoid hyperemesis syndrome (CHS). Treatment has presented with controversy due to lack of sufficient data to guide provider treatment. Traditional anti-emetics continue as first line therapies, although their efficacy has demonstrated variable management success. Recent data in adult patients have described successful and safe treatment with the first-generation antipsychotic, haloperidol. However, evidence for the efficacy and safety and that of other therapeutic strategies (such as benzodiazepines) in pediatric patients remains limited Objective: To describe the diagnostic prevalence, management trends, and safety of haloperidol in pediatric patients 11-21 years diagnosed with (CHS) from 2012-2023 Design/Methods: We performed a multi-center retrospective cohort study across 47 hospitals in the Pediatric Health Information System (PHIS) database for children 0-17 years old with a principal or secondary ICD-9/10 code diagnosis [ F12.1, F12.2, 3043, 3052] from 1/1/2012 to 7/1/2023 of pediatric patients ages 11-21 years from 2012-2021. Demographic, medical comorbidity, and hospital course data were extracted from PHIS and summarized. Rates of hospitalization with CHS were calculated annually in aggregate and at the hospital level. Our primary predictor was the use of haloperidol and our primary outcome was hospital length of stay (LOS). Secondary outcomes included 30-day same-cause readmission and the incidence of extrapyramidal symptoms. Generalized mixed models will be utilized to model the relationship between haloperidol use and primary and secondary outcomes, accounting for clustering by hospital site. This study is approved by the Johns Hopkins Institutional Review Board (IRB00415989).
