title: Progesterone for Traumatic Brain Injury: A Meta-Analysis Review of Randomized Controlled Trials.
abstract: OBJECTIVE
  To conduct a meta-analysis to determine whether progesterone, compared with placebo or no treatment, influences mortality and neurologic outcome in traumatic brain injury (TBI).
  
  
  METHODS
  To identify eligible studies, systematic searches for randomized controlled trials of progesterone treatment in TBI were conducted in PubMed, Web of Science, EMBASE, Cochrane Library, and ClinicalTrials.gov databases. The search yielded 8 studies that were included in the meta-analysis. Included data were study characteristics, patient demographics, baseline characteristics, progesterone treatment protocol, main outcome of mortality, and secondary neurologic outcome evaluated using the Glasgow Outcome Scale.
  
  
  RESULTS
  The 8 studies comprised 2585 patients. The meta-analysis indicated that there was no evidence that progesterone treatment decreased the risk of mortality in patients with TBI; the overall risk ratio was 0.852 (95% confidence interval, 0.632-1.144; P = 0.284). In the secondary outcome analysis, progesterone had no neuroprotective role in improving neurologic outcome; the overall risk ratio was 1.151 (95% confidence interval, 0.0991-1.338; P = 0.06). Subgroup analysis according to the degree of injury assessed by the Glasgow Coma Scale demonstrated similar results.
  
  
  CONCLUSIONS
  This study is the largest meta-analysis conducted to date to determine whether progesterone is effective in the treatment of TBI. The findings indicate that progesterone treatment does not decrease mortality or improve neurologic outcome in patients with TBI.
authors.affiliation: Department of Neurosurgery, People's Hospital Affiliated of Jiangsu University, Zhenjiang, Jiangsu, China.
authors.forename: Xin-Yu
authors.initials: XY
authors.lastname: Lu
authors.affiliation: Department of Plastic Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu, China. Electronic address: zjsunhui1973@163.com.
authors.forename: Hui
authors.initials: H
authors.lastname: Sun
authors.affiliation: Department of Neurosurgery, People's Hospital Affiliated of Jiangsu University, Zhenjiang, Jiangsu, China.
authors.forename: Qiao-Yu
authors.initials: QY
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, People's Hospital Affiliated of Jiangsu University, Zhenjiang, Jiangsu, China.
authors.forename: Pei-Song
authors.initials: PS
authors.lastname: Lu
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000401:mortality* / Q000517:prevention & control*; D000070642:Brain Injuries, Traumatic / Q000188:drug therapy* / Q000401:mortality*; D015984:Causality; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use; D015995:Prevalence; D011374:Progesterone / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data*; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018696:Neuroprotective Agents; D011374:Progesterone
keywords: Meta-analysis; Mortality; Outcome; Progesterone; Traumatic brain injury