https://doi.org/10.4081/ecj.2026.15189
Age as a predictor for hospital admission and length of stay in pediatric cannabis exposure
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 10 July 2026
Pediatric cannabis exposure is an increasing cause of Emergency Department (ED) visits and hospital admissions. Prior research has shown that younger children may experience more severe symptoms from unintentional ingestion, leading to higher admission rates but the association between age and likelihood of admission versus discharge from the ED among older children and adolescents remains underexplored. This study sought to evaluate whether age was a predictor of admission to a hospital following accidental cannabis ingestion in pediatric patients. The 2020 National Emergency Department Sample was used to identify patients with cannabis exposure (as defined by the ICD-10 codes). The primary outcome measure was admission to the hospital. Patients were grouped in the following age categories: 0-5 years, 6-11 years, 12-18 years, and 19-21 years. Pediatric patients aged 6 or older had lower odds of admission to a hospital following accidental cannabis exposure (P<0.001). However, for patients admitted to a hospital, older age was associated with longer length of stay (P<0.001). Although older pediatric age was associated with lower odds of hospital admission following accidental cannabis exposure compared to patients less than six years old, older age was associated with longer length of hospital stay.
Downloads
1. Roehler DR. Cannabis-involved emergency department visits among persons aged <25 years before and during the COVID-19 pandemic — United States, 2019–2022. MMWR Morb Mortal Wkly Rep 2023;72:758-65. DOI: https://doi.org/10.15585/mmwr.mm7228a1
2. Shen JJ, Shan G, Kim PC, et al. Trends and related factors of cannabis-associated emergency department visits in the United States: 2006-2014. J Addict Med 2019;13:193-200. DOI: https://doi.org/10.1097/ADM.0000000000000479
3. MacCoun RJ, Mello MM. Half-baked — the retail promotion of marijuana edibles. New Engl J Med 2015;372:989-91. DOI: https://doi.org/10.1056/NEJMp1416014
4. Dubinin A, Bialostozky M, Richardson A, Laub N. Presentation, management, and child protective service reporting of children who test positive for cannabis in an emergency room setting. Pediatr Emerg Care 2024;40:443. DOI: https://doi.org/10.1097/PEC.0000000000003145
5. Wang GS, Le Lait MC, Deakyne SJ, et al. Unintentional pediatric exposures to marijuana in Colorado, 2009-2015. JAMA Pediatrics 2016;170:e160971. DOI: https://doi.org/10.1001/jamapediatrics.2016.0971
6. Council on Child and Adolescent Health. Age limits of pediatrics. Pediatrics 1988;81:736. DOI: https://doi.org/10.1542/peds.81.5.736
7. Williams K, Thomson D, Seto I, et al. Standard 6: age groups for pediatric trials. Pediatrics 2012;129:S153-60. DOI: https://doi.org/10.1542/peds.2012-0055I
8. Padoan F, Colombrino C, Sciorio F, et al. Concerns related to the consequences of pediatric cannabis use: a 360-degree view. Children 2023;10:1721. DOI: https://doi.org/10.3390/children10111721
9. Menon S, Symons JM, Selewski DT. Acute kidney injury. Pediatr Rev 2023;44:265-79. DOI: https://doi.org/10.1542/pir.2021-005438
10. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th edition. American Psychiatric Association; 2013. DOI: https://doi.org/10.1176/appi.books.9780890425596
11. Onders B, Casavant MJ, Spiller HA, et al. Marijuana Exposure Among Children Younger Than Six Years in the United States. Clin Pediatri 2016;55:89912. DOI: https://doi.org/10.1177/0009922815589912
12. Tweet MS, Nemanich A, Wahl M. Pediatric edible cannabis exposures and acute toxicity: 2017–2021. Pediatrics 2023;151:e2022057761. DOI: https://doi.org/10.1542/peds.2022-057761
13. Claudet I, Mouvier S, Labadie M, et al. Unintentional cannabis intoxication in toddlers. Pediatrics 2017;140:e20170017. DOI: https://doi.org/10.1542/peds.2017-0017
14. Pélissier F, Claudet I, Pélissier-Alicot AL, Franchitto N. Parental cannabis abuse and accidental intoxications in children: prevention by detecting neglectful situations and at-risk families. Pediatr Emerg Care 2014;30:862. DOI: https://doi.org/10.1097/PEC.0000000000000288
15. Leubitz A, Spiller HA, Jolliff H, Casavant M. Prevalence and clinical characteristics of unintentional ingestion of marijuana in children younger than 6 years in states with and without legalized marijuana laws. Pediatr Emerg Care 2021;37:e969-e973. DOI: https://doi.org/10.1097/PEC.0000000000001841
16. Bennett CE, Venkataramani A, Henretig FM, et al. Recent trends in marijuana-related hospital encounters in young children. Acad Pediatr 2022;22:592-7. DOI: https://doi.org/10.1016/j.acap.2021.07.018
17. Grotenhermen F. Pharmacokinetics and pharmacodynamics of cannabinoids. Clin Pharmacokinet 2003;42:327-60. DOI: https://doi.org/10.2165/00003088-200342040-00003
18. Lafaye G, Karila L, Blecha L, Benyamina A. Cannabis, cannabinoids, and health. Dialogues Clin Neurosci 2017;19:309-16. DOI: https://doi.org/10.31887/DCNS.2017.19.3/glafaye
19. Saravay SM, Lavin M. Psychiatric comorbidity and length of stay in the general hospital: a critical review of outcome studies. Psychosomatics 1994;35:233-52. DOI: https://doi.org/10.1016/S0033-3182(94)71772-2
20. Sarvet AL, Wall MM, Keyes KM, et al. Recent rapid decrease in adolescents’ perception that marijuana is harmful, but no concurrent increase in use. Drug Alcohol Dependence 2018;186:68-74. DOI: https://doi.org/10.1016/j.drugalcdep.2017.12.041
21. Monte AA, Shelton SK, Mills E, et al. Acute illness associated with cannabis use, by route of exposure: an observational study. Ann Intern Med 2019;170:531-7. DOI: https://doi.org/10.7326/M18-2809
22. Sturm R, Ringel JS, Andreyeva T. Geographic disparities in children’s mental health care. Pediatrics 2003;112:e308. DOI: https://doi.org/10.1542/peds.112.4.e308
23. Langer T, Limuti R, Tommasino C, et al. Intravenous fluid therapy for hospitalized and critically ill children: rationale, available drugs and possible side effects. Anaesthesiol Intensive Ther 2018;50:49-58.
24. Chisavu F, Gafencu M, Stroescu R, et al. Acute kidney injury in children: incidence, awareness and outcome—a retrospective cohort study. Sci Rep 2023;13:15778. DOI: https://doi.org/10.1038/s41598-023-43098-7
25. Hsu CN, Chen HL, Tain YL. Epidemiology and outcomes of community-acquired and hospital-acquired acute kidney injury in children and adolescents. Pediatr Res 2018;83:622-9. DOI: https://doi.org/10.1038/pr.2017.262
26. Goyal A, Daneshpajouhnejad P, Hashmi MF, Bashir K. Acute Kidney Injury. In: StatPearls. StatPearls Publishing; 2024. http://www.ncbi.nlm.nih.gov/books/NBK441896/
27. Simms-Williams N, Nagakumar P, Thayakaran R, et al. Risk factors for asthma-related hospital and intensive care admissions in children, adolescents and adults: a cohort study using primary and secondary care data. BMJ Open Respiratory Res 2024;11:e001746. DOI: https://doi.org/10.1136/bmjresp-2023-001746
28. Santo L, Peters ZJ, DeFrances CJ. Emergency department visits among adults with mental health disorders: United States, 2017-2019. NCHS Data Brief 2021;426:1-8. DOI: https://doi.org/10.15620/cdc:112081
29. Ladha KS, Eikermann M. Codifying healthcare – big data and the issue of misclassification. BMC Anesthesiol 2015;15:179. DOI: https://doi.org/10.1186/s12871-015-0165-y
30. Wanqing Z, Paul R. C, Doré R. L. Racial and Geographic Differences in Hospitalizations for Pediatric Opioid Use Disorders. Int Arch Public Health Community Med. 2020;4(2). doi:10.23937/2643-4512/1710042 DOI: https://doi.org/10.23937/2643-4512/1710042
31. State Medical Cannabis Laws. Available from: https://www.ncsl.org/health/state-medical-cannabis-laws
32. Häuser W, Petzke F, Fitzcharles M. Efficacy, tolerability and safety of cannabis-based medicines for chronic pain management – An overview of systematic reviews. Eur J Pain 2018;22:455-70. DOI: https://doi.org/10.1002/ejp.1118
33. Haney M, Evins AE. Does cannabis cause, exacerbate or ameliorate psychiatric disorders? An oversimplified debate discussed. Neuropsychopharmacology 2016;41:393-401. DOI: https://doi.org/10.1038/npp.2015.251
34. Zarrabi AJ, Frediani JK, Levy JM. The State of Cannabis Research Legislation in 2020. N Engl J Med 2020;382:1876-7. DOI: https://doi.org/10.1056/NEJMp2003095
35. MacCallum CA, Lo LA, Boivin M. Is medical cannabis safe for my patients? A practical review of cannabis safety considerations. Eur J Intern Med 2021;89:10-8. DOI: https://doi.org/10.1016/j.ejim.2021.05.002
CRediT authorship contribution
David Nacouzi, writing-original draft, writing-review and editing; Aliba Syed, writing-review and editing; Dmitry Tumin, data curation, formal analysis, methodology, writing-review and editing; Taha Lodhi, writing- original draft, writing- review and editing; Taylor Stamey, writing- original draft, writing- review and editing; Kori Brewer, conceptualization, project administration, supervision, writing- original draft, writing- review and editing.
Supporting Agencies
Data Availability Statement
Availability of these data is restricted. Data were obtained from the National Emergency Department Sample (NEDS) database.
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
