Elsevier

The Lancet

Volume 365, Issue 9475, 4–10 June 2005, Pages 1957-1959
The Lancet

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

https://doi.org/10.1016/S0140-6736(05)66552-XGet rights and content

Summary

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.

References (5)

  • R Peto

    Possible explanations of the CRASH result

    Lancet

    (2005)
  • Effect of intravenous corticosteroids on death within 14 days in 10 008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial

    Lancet

    (2004)
There are more references available in the full text version of this article.

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