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Evidence summaries

Corticosteroids for Acute Traumatic Brain Injury

Corticosteroids are not beneficial in acute traumatic brain injury and may even increase death rate. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 20 studies with a total of 12 303 subjects. The effect of corticosteroids on the risk of death was reported in 17 included trials. Due to significant heterogeneity a pooled estimate of the risk of death was not calculated. The largest trial, with about 80% of all randomised participants, found a significant increase in the risk ratio of death with steroids 1.15 (95% CI 1.07 to 1.24) and a relative risk of death or severe disability of 1.05 (95% CI 0.99 to 1.10). For infections the pooled risk ratio from five trials was 1.03 (95% CI 0.99 to 1.07) and for the ten trials reporting gastrointestinal bleeding 1.23 (95% CI 0.91 to 1.67).

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    References

    • Alderson P, Roberts I. Corticosteroids for acute traumatic brain injury. Cochrane Database Syst Rev 2005;(1):CD000196. [PubMed]

Primary/Secondary Keywords