MRC CRASH is a randomised controlled trial (ISRCT- N74459797) of the effect of corticosteroids on death and disability after head injury. We randomly alloca ted 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 (methylprednisolon e) or placebo. Data at 6 months were obtained for 9673 (96.7% ) patients. The r isk of death was higher in the corticosteroid group than in the placebo group (1 248 [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- 1.1 0; p=0.079). There was no evidence that the effect of corticosteroids differed b y injury severity or time since injury. These results lend support to our earlie r conclusion that corticosteroids should not be used routinely in the treatment of head injury.
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