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Treatment
Methylprednisolone was associated with an increase in death after head injury

https://doi.org/10.1136/ebn.8.2.51

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    CRASH Trial Collaborators. Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial. Lancet 2004;364:1321–8.OpenUrlCrossRefPubMedWeb of Science

    Q In patients with head injury, is early administration of methylprednisolone better than placebo for reducing death?

    METHODS

    Embedded ImageDesign:

    randomised placebo controlled trial (Corticosteroid Randomisation After Significant Head injury [CRASH]).

    Embedded ImageAllocation:

    concealed.

    Embedded ImageBlinding:

    blinded (clinicians and patients).

    Embedded ImageFollow up period:

    2 weeks.

    Embedded ImageSetting:

    239 hospitals in 49 countries.

    Embedded ImagePatients:

    10 008 patients who were ⩾16 years of age (mean age 37 y, 81% men) and had sustained a head injury within 8 hours, had a Glasgow Coma Score (GCS) ⩽14, and whose treating physician was uncertain whether to treat with corticosteroids.

    Embedded ImageIntervention:

    a loading dose of methylprednisolone, 2 g over 1 hour in a 100 ml infusion, followed up by a maintenance …

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    Footnotes

    • For correspondence: CRASH Trials Coordinating Centre, London School of Hygiene and Tropical Medicine, London, UK. crashlshtm.ac.uk

    • Sources of funding: UK Medical Research Council, Pharmacia and Upjohn.