Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months.


Edwards, P; Arango, M; Balica, L; Cottingham, R; El-Sayed, H; Farrell, B; Fernandes, J; Gogichaisvili, T; Golden, N; Hartzenberg, B; Husain, M; Ulloa, MI; Jerbi, Z; Khamis, H; Komolafe, E; Laloe, V; Lomas, G; Ludwig, S; Mazairac, G; Munoz Sanchez, MdeL; Nasi, L; Olldashi, F; Plunkett, P; Roberts, I; Sandercock, P; Shakur, H; Soler, C; Stocker, R; Svoboda, P; Trenkler, S; Venkataramana, NK; Wasserberg, J; Yates, D; Yutthakasemsunt, S; (2005) Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months. Lancet, 365 (9475). pp. 1957-9. ISSN 0140-6736 DOI: https://doi.org/10.1016/S0140-6736(05)66552-X

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Abstract

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.

Item Type: Article
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Population Health (2012- ) > Dept of Nutrition and Public Health Interventions Research (2003-2012)
Faculty of Epidemiology and Population Health > Dept of Population Health (2012- )
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 15936423
Web of Science ID: 229587800030
URI: http://researchonline.lshtm.ac.uk/id/eprint/13437

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