EVALUATION OF BENEFICIAL EFFECTS OF STEROIDS AFTER HEAD INJURY

Abstract

While severe traumatic brain injury (TBl) has a mortality rate of 35-40%, the socioeconomic impact of moderate and severe head injury is quite severe. Steroids are a debatable therapy in the management of TBL Adrenal insufficiency and disturbed circadian rhythm in critically ill head trauma patients is quite common.

The aim of this work is to re-evaluate the use of steroids after CRASH trial 2004 that stated that steroids should not be given routinely to head trauma patients whatever the severity and to assess the prevalence of adrenal insufficiency in the critically ill head trauma patients and its relation to the outcome.

The study included 19 cases, patients who received LV. steroids, (18 males, mean age 28.63±8.88 years), and 22 controls (17 males, mean age 29.07±12.75 years).

Nineteen cases were treated with dexamethasone, 8 mg, every 8 hours for 48 hours, and follow up by G.CS. was done at discharge or 2 weeks whatever earlier.

Mortality was less in cases (patients who received steroids) as I 0.53% of cases (2 of 19 patients) died compared to (4 of22 patients), 18.18% of controls, however the difference was not statistically significant Hospital stay was (5.47%±7.01) for cases and (5.82±3.69%) for controls. The difference was not statistically significant

There was statistically significant difference towards less mortality in moderate and mild cases compared to severe cases, however there was no statistically significant difference between mild and moderate cases regarding mortality.