Final results of MRC CRASH, a randomised placebo-controlled trial of intravenous corticosteroid in adults with head injury - outcomes at 6 months

Colin Baigent, Michael Bracken, David Chadwick, Kevin Curley, Lelia Duley, Barbara Farrell, Marcel Haegi, Gabrielle Lomas, Graham Nickson, Richard Peto, John Pickard, Ian Roberts, Peter Sandercock, Graham Teasdale, Jonathan Wasserberg, David Yates, Rory Collins, Stephen Haines, Stephen MacMahon, Charles WarlowPhil Edwards, Arbara Farrell, Gabrielle Lomas, Nin Ritchie, Ian Roberts, Peter Sandercock, Aleema Shakur, Graham Teasdale, Jonathan Wasserberg, David Yates, Haleema Shakur, Ian Roberts, Phil Edwards, Maria Ramos, Lin Barnetson, Janice Fernandes, Donna Tooth, Cari Free, Leena Narayanan, Johan Collander, Julia Abernethy, Josephine Bardswell, Nin Ritchie, Reshma Mashru, Catherine Godward, Elizabeth Afolabi, Adrian Ritchie, Tessa Hosford, Shiela Pantrini, Sheila Massey, Amber Collingwood, Phil Edwards, Miguel Arango, Laura Balica, Rowland Cottingham, Hesham El-Sayed, Barbara Farrell, Janice Fernandes, Tamar Gogichaisvili, Nyoman Golden, Bennie Hartzenberg, 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, N. K. Venkataramana, Jonathan Wasserberg, David Yates, Surakrant Yutthakasemsunt

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482 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1957-1959
Number of pages3
JournalThe Lancet
Volume365
Issue number9475
DOIs
StatePublished - Jun 4 2005

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