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Methylprednisolone was associated with an increase in death after head injury

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


Embedded ImageDesign:

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

Embedded ImageAllocation:


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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