The Pharmaceutical Journal
Vol 274 No 7352 p670
4 June 2005

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Corticosteroids raise death rate in head injuries by 15 pc

Use of corticosteroids to treat head injury is associated with a 15 per cent higher risk of death within six months compared with placebo, follow-up data from the CRASH (corticosteroid randomisation after significant head injury) trial have shown (published online at www.thelancet.com).

Earlier analysis of the data had indicated that corticosteroids were associated with an 18 per cent higher risk of death within two weeks, although the mechanism behind this increase was not clear (PJ, 16 October 2004, p552).

At total of 10,008 adults with head injury were randomised to a 48-hour infusion of methylprednisolone or placebo. The risk of death was higher in the corticosteroid group than in the placebo group (25.7 per cent compared with 22.3 per cent), as was the risk of death or severe disability (38.1 per cent compared with 36.3 per cent).