Corticosteroids for acute traumatic brain injury

Corticosteroids are not beneficial in acute traumatic brain injury and may even increase death rate.

A Cochrane review 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).

The following decision support rules contain links to this evidence summary:

• Corticosteroids are not recommended for acute traumatic brain injury

Ədəbiyyat

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