Update on progress in the international, multicenter, randomized, controlled trial of corticosteroids after significant head injury (Medical Research Council CRASH Trial).
OBJECTIVE
To provide an update on the progress of the multicenter, randomized, controlled trial of corticosteroids after significant head injury (CRASH).


RESULTS
After a successful pilot phase, the main phase of the CRASH Trial began in March 2001. By June 2002, 107 hospitals from 31 countries were participating in the trial, and together had recruited 3000 patients. Nine hundred patients (30%) had mild head injury, 885 (30%) had moderate head injury, and 1215 (40%) had severe head injury. A total of 1941 (65%) patients were randomized within 3 hours of injury. Outcome at 2 weeks from injury was known for 2933 (98%) patients, of whom 557 (19%) died. At the time of writing, 6-month follow-up for the first 1500 patients was nearly complete. Vital status was known for 1429 (95%) of the 1500 patients, of whom 313 (22%) had died. Functional status based on the Glasgow Outcome Scale was known for 1391 (93%) of the 1500 patients: 22% were dead, 16% were severely disabled, 23% were moderately disabled, and 39% had made a good recovery.


CONCLUSIONS
The CRASH Trial is a randomized, placebo-controlled, multicenter trial of a 48-hour corticosteroid infusion after significant head injury and is now the largest head injury trial ever conducted. The efforts of the national coordinators have shown that it is possible to enroll and follow up very large numbers of head-injured patients.
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000188:drug therapy; D002648:Child; D006259:Craniocerebral Trauma / Q000188:drug therapy*; D005260:Female; D015600:Glasgow Coma Scale; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones