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Q In patients with head injury, is early administration of methylprednisolone better than placebo for reducing death?
METHODS
Design:
randomised placebo controlled trial (Corticosteroid Randomisation After Significant Head injury [CRASH]).
Allocation:
concealed.
Blinding:
blinded (clinicians and patients).
Follow up period:
2 weeks.
Setting:
239 hospitals in 49 countries.
Patients:
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.
Intervention:
a loading dose of methylprednisolone, 2 g over 1 hour in a 100 ml infusion, followed up by a maintenance …
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.