Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Steroids increase death risk from traumatic head injury

24.01.2005


The common use of anti-inflammatory steroids for traumatic head injuries like those from car crashes may actually increase the risk of death, according to a new review of studies about the treatment.1



A previous review found there was not enough evidence to recommend that routine use of steroids be stopped. This newer analysis published by the British-based Cochrane Library draws heavily from a recent study of corticosteroid treatment for brain injury, including coma and concussion, that included 10,008 patients, more than all similar studies combined.

The large study found that patients treated with corticosteroids were 18 percent more likely to die from their brain injury than those who did not take the drugs. Among the patients who received steroid treatment, 21 percent ,or 1,052 of the 4,985 treated, died, compared to 18 percent who received a placebo. "The significant increase in death with steroids found in this trial suggests that steroids should no longer be routinely used in people with traumatic head injury," says Dr. Phil Alderson, lead author of the Cochrane study.


The review appears in the January issue of The Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

Corticosteroids are anti-inflammatory hormones used to treat all kinds of inflammation, from joint injury to asthma. They differ from anabolic steroids, the sex hormones like androgen, which are typically used to increase muscle mass and improve athletic performance. Corticosteroids are "widely used in medicine to treat inflammation," Alderson explains. "It is thought that some of the damage after a brain injury results from inflammation following the initial injury and that reducing inflammation might reduce this secondary injury."

In the case of severe head injuries, the inflammation leads to swelling of the brain and its surrounding tissues, which in turns creates pressure in the skull that may lead to complications or death.

The 17 studies on steroid use and the risk of death examined by Alderson and colleagues included a total of 12,083 patients of all ages with clinically diagnosed traumatic brain injury, some of whom received steroid treatment within seven days of their injury.

The cause of death in patients who received steroid treatment in the new large trial was unclear, according the study’s authors. Some researchers have suggested that corticosteroids increase the likelihood of death by interfering with adrenal gland function. Steroid use did not reduce the risks of infection among these patients, the authors concluded. Gastrointestinal bleeding complications did not seem to increase or decrease with steroid treatment. Not all physicians routinely prescribe corticosteroids, Alderson says, but he notes that use of the drugs "was quite widespread," when The Cochrane Collaboration first reviewed the treatment in 1997.

A 2000 survey of brain trauma treatment centers in the United States found that one-third of those centers still use corticosteroids routinely, according Jamshid Ghajar, president of The Brain Trauma Foundation, which conducted the survey. According to the U.S. Centers for Disease Control and Prevention, 1.4 million American suffer traumatic brain injuries a year, and 50,000 die from it. "Since this often occurs in young people and is long term, traumatic brain injury-related disability is a major cause of ill health worldwide," Alderson says.

1. Alderson et al. Corticosteriods for acute traumatic brain injury. The Cochrane Database of Systematic Reviews 2005, Issue 1

Phil Alderson | EurekAlert!
Further information:
http://www.cochrane.co.uk
http://www.hbns.org
http://www.cfah.org

More articles from Health and Medicine:

nachricht Satellites, airport visibility readings shed light on troops' exposure to air pollution
09.12.2016 | Veterans Affairs Research Communications

nachricht Oxygen can wake up dormant bacteria for antibiotic attacks
08.12.2016 | Penn State

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Electron highway inside crystal

Physicists of the University of Würzburg have made an astonishing discovery in a specific type of topological insulators. The effect is due to the structure of the materials used. The researchers have now published their work in the journal Science.

Topological insulators are currently the hot topic in physics according to the newspaper Neue Zürcher Zeitung. Only a few weeks ago, their importance was...

Im Focus: Significantly more productivity in USP lasers

In recent years, lasers with ultrashort pulses (USP) down to the femtosecond range have become established on an industrial scale. They could advance some applications with the much-lauded “cold ablation” – if that meant they would then achieve more throughput. A new generation of process engineering that will address this issue in particular will be discussed at the “4th UKP Workshop – Ultrafast Laser Technology” in April 2017.

Even back in the 1990s, scientists were comparing materials processing with nanosecond, picosecond and femtosesecond pulses. The result was surprising:...

Im Focus: Shape matters when light meets atom

Mapping the interaction of a single atom with a single photon may inform design of quantum devices

Have you ever wondered how you see the world? Vision is about photons of light, which are packets of energy, interacting with the atoms or molecules in what...

Im Focus: Novel silicon etching technique crafts 3-D gradient refractive index micro-optics

A multi-institutional research collaboration has created a novel approach for fabricating three-dimensional micro-optics through the shape-defined formation of porous silicon (PSi), with broad impacts in integrated optoelectronics, imaging, and photovoltaics.

Working with colleagues at Stanford and The Dow Chemical Company, researchers at the University of Illinois at Urbana-Champaign fabricated 3-D birefringent...

Im Focus: Quantum Particles Form Droplets

In experiments with magnetic atoms conducted at extremely low temperatures, scientists have demonstrated a unique phase of matter: The atoms form a new type of quantum liquid or quantum droplet state. These so called quantum droplets may preserve their form in absence of external confinement because of quantum effects. The joint team of experimental physicists from Innsbruck and theoretical physicists from Hannover report on their findings in the journal Physical Review X.

“Our Quantum droplets are in the gas phase but they still drop like a rock,” explains experimental physicist Francesca Ferlaino when talking about the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ICTM Conference 2017: Production technology for turbomachine manufacturing of the future

16.11.2016 | Event News

Innovation Day Laser Technology – Laser Additive Manufacturing

01.11.2016 | Event News

#IC2S2: When Social Science meets Computer Science - GESIS will host the IC2S2 conference 2017

14.10.2016 | Event News

 
Latest News

Researchers identify potentially druggable mutant p53 proteins that promote cancer growth

09.12.2016 | Life Sciences

Scientists produce a new roadmap for guiding development & conservation in the Amazon

09.12.2016 | Ecology, The Environment and Conservation

Satellites, airport visibility readings shed light on troops' exposure to air pollution

09.12.2016 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>