title: Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury-outcomes at 6 months.
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.
authors.forename: Phil
authors.initials: P
authors.lastname: Edwards
authors.forename: Miguel
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authors.lastname: Arango
authors.forename: Laura
authors.initials: L
authors.lastname: Balica
authors.forename: Rowland
authors.initials: R
authors.lastname: Cottingham
authors.forename: Hesham
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authors.lastname: El-Sayed
authors.forename: Barbara
authors.initials: B
authors.lastname: Farrell
authors.forename: Janice
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authors.lastname: Fernandes
authors.forename: Tamar
authors.initials: T
authors.lastname: Gogichaisvili
authors.forename: Nyoman
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authors.lastname: Golden
authors.forename: Bennie
authors.initials: B
authors.lastname: Hartzenberg
authors.forename: Mazhar
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authors.lastname: Husain
authors.forename: Mario Izurieta
authors.initials: MI
authors.lastname: Ulloa
authors.forename: Zouheir
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authors.lastname: Jerbi
authors.forename: Hussein
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authors.lastname: Khamis
authors.forename: Edward
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authors.lastname: Komolafe
authors.forename: Véronique
authors.initials: V
authors.lastname: Laloë
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Lomas
authors.forename: Silke
authors.initials: S
authors.lastname: Ludwig
authors.forename: Guy
authors.initials: G
authors.lastname: Mazairac
authors.forename: Maria de los Angeles
authors.initials: Mde L
authors.lastname: Muñoz Sanchéz
authors.forename: Luis
authors.initials: L
authors.lastname: Nasi
authors.forename: Fatos
authors.initials: F
authors.lastname: Olldashi
authors.forename: Patrick
authors.initials: P
authors.lastname: Plunkett
authors.forename: Ian
authors.initials: I
authors.lastname: Roberts
authors.forename: Peter
authors.initials: P
authors.lastname: Sandercock
authors.forename: Haleema
authors.initials: H
authors.lastname: Shakur
authors.forename: Caridad
authors.initials: C
authors.lastname: Soler
authors.forename: Reto
authors.initials: R
authors.lastname: Stocker
authors.forename: Petr
authors.initials: P
authors.lastname: Svoboda
authors.forename: Stefan
authors.initials: S
authors.lastname: Trenkler
authors.forename: N K
authors.initials: NK
authors.lastname: Venkataramana
authors.forename: Jonathan
authors.initials: J
authors.lastname: Wasserberg
authors.forename: David
authors.initials: D
authors.lastname: Yates
authors.forename: Surakrant
authors.initials: S
authors.lastname: Yutthakasemsunt
mesh_terms: D006259:Craniocerebral Trauma / Q000188:drug therapy* / Q000401:mortality; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008775:Methylprednisolone / Q000008:administration & dosage*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D008775:Methylprednisolone