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Articles for Doctors
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FINAL
RESULTS OF MRC CRASH, A RANDOMISED
PLACEBO CONTROLLED TRIAL OF
INTRAVENOUS CORTICOSTEROID IN ADULTS
WITH HEAD INJURY-OUTCOMES AT 6
MONTHS
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MRC CRASH is a randomised
controlled trial (ISRCTN74459797) of the
effect of corticosteroids on death and
disability after head injury. We randomly
allocated 10,008 adults with head injury and
a Glasgow Coma Scale score of 14 or less,
within 8 h of injury, to a 48-h infusion of
corticosteroid (methylprednisolone) or
placebo. Data at 6 months were obtained for
9673 (96.7%) patients. The risk of death was
higher in the corticosteroid group than in
the placebo group (1248 [25.7%] vs 1075
[22.3%] deaths; relative risk 1.15, 95% CI
1.07-1.24; p=0.0001), as was the risk of
death or severe disability (1828 [38.1%] vs
1728 [36.3%] dead or severely disabled;
1.05, 0.99-1.10; p=0.079). There was no
evidence that the effect of corticosteroids
differed by injury severity or time since
injury. These results lend support to our
earlier conclusion that corticosteroids
should not be used routinely in the
treatment of head injury.
Autor:
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ECUADORIAN
SOCIETY OF TRAUMA
Memories of Pan-american
Congress of Trauam
Guayaquil -
November 2005
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