Consequences of high-dose steroid therapy for acute spinal cord injury.
OBJECTIVE
High-dose Solu-Medrol (Upjohn, Kalamazoo, Mich) therapy has become standard care in the management of acute spinal cord injury (ASCI). This study attempts to define the adverse effects that Solu-Medrol therapy has on these patients.


METHODS
Retrospective review with historical control.


METHODS
From May 1990 to April 1994, all patients with ASCI admitted within 8 hours of injury received high-dose Solu-Medrol per the National Acute Spinal Injury Study (NASCIS-2) protocol. Their demographic and outcome parameters were compared with those of a group admitted from March 1986 to December 1993 with an associated ASCI who received no steroid therapy.


RESULTS
Steroid therapy was associated with a 2.6-fold increase in the incidence of pneumonia and an increase in ventilated and intensive care days. However, it was associated with a decrease in duration of rehabilitation and had no significant impact on other outcome parameters, including mortality.


CONCLUSIONS
Although the NASCIS-2 protocol may promote early infectious complications, it has no adverse impact on long-term outcome in patients with ASCIs.
Gerndt
S J
SJ
Division of Trauma, Burn, and Emergency Surgery, University of Michigan, Ann Arbor, USA.
Rodriguez
J L
JL
Pawlik
J W
JW
Taheri
P A
PA
Wahl
W L
WL
Micheals
A J
AJ
Papadopoulos
S M
SM
D000063:Accidents, Traffic; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008776:Methylprednisolone Hemisuccinate / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D009104:Multiple Trauma; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000188:drug therapy*; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating
D005938:Glucocorticoids; D008776:Methylprednisolone Hemisuccinate