Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months.
;
Miguel Arango;
Laura Balica;
Rowland Cottingham;
Hesham El-Sayed;
Barbara Farrell;
Janice Fernandes;
Tamar Gogichaisvili;
Nyoman Golden;
Bennie Hartzenberg;
+25 more...
Mazhar Husain;
Mario Izurieta Ulloa;
Zouheir Jerbi;
Hussein Khamis;
Edward Komolafe;
Véronique Laloë;
Gabrielle Lomas;
Silke Ludwig;
Guy Mazairac;
Maria de los Angeles Muñoz Sanchéz;
Luis Nasi;
Fatos Olldashi;
Patrick Plunkett;
Ian Roberts ;
Peter Sandercock;
Haleema Shakur ;
Caridad Soler;
Reto Stocker;
Petr Svoboda;
Stefan Trenkler;
NK Venkataramana;
Jonathan Wasserberg;
David Yates;
Surakrant Yutthakasemsunt;
CRASH trial collaborators;
(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. 1957-1959.
ISSN 0140-6736
DOI: 10.1016/S0140-6736(05)66552-X
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.