Evid Based Nurs 8:51 doi:10.1136/ebn.8.2.51
  • Treatment

Methylprednisolone was associated with an increase in death after head injury

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



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




blinded (clinicians and patients).

GraphicFollow up period:

2 weeks.


239 hospitals in 49 countries.


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.


a loading dose of methylprednisolone, 2 g over 1 hour in a 100 ml infusion, followed up by a maintenance infusion of 0.4 g over 48 hours in a 20 ml/h infusion (n = 5007) or placebo (n = 5001).


all cause mortality. Recruitment was planned for 20 000 …

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