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 Nanoparticles as a Solution against Antibiotic Resistance?
15.12.2017 | Friedrich-Schiller-Universität Jena

nachricht Plasmonic biosensors enable development of new easy-to-use health tests
14.12.2017 | Aalto University

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: First-of-its-kind chemical oscillator offers new level of molecular control

DNA molecules that follow specific instructions could offer more precise molecular control of synthetic chemical systems, a discovery that opens the door for engineers to create molecular machines with new and complex behaviors.

Researchers have created chemical amplifiers and a chemical oscillator using a systematic method that has the potential to embed sophisticated circuit...

Im Focus: Long-lived storage of a photonic qubit for worldwide teleportation

MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.

Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...

Im Focus: Electromagnetic water cloak eliminates drag and wake

Detailed calculations show water cloaks are feasible with today's technology

Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...

Im Focus: Scientists channel graphene to understand filtration and ion transport into cells

Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.

To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...

Im Focus: Towards data storage at the single molecule level

The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.

Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

AKL’18: The opportunities and challenges of digitalization in the laser industry

07.12.2017 | Event News

 
Latest News

Engineers program tiny robots to move, think like insects

15.12.2017 | Power and Electrical Engineering

One in 5 materials chemistry papers may be wrong, study suggests

15.12.2017 | Materials Sciences

New antbird species discovered in Peru by LSU ornithologists

15.12.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>