Effect of progesterone administration on prognosis of patients with diffuse axonal injury due to severe head trauma

Clin Neurol Neurosurg. 2013 Oct;115(10):2019-22. doi: 10.1016/j.clineuro.2013.06.013. Epub 2013 Jul 18.

Abstract

Objective: Severe traumatic brain injury (TBI) has a major role in mortality rate among the other types of trauma. The aim of this clinical study was to assess the effect of progesterone on the improvement of neurologic outcome in patients with acute severe TBI.

Methods: A total of 76 patients who had arrived within 8h of injury with a Glasgow Coma Score≤8 were enrolled in the study. In a randomized style 38 received progesterone (1mg/kg per 12h for 5 days) and 38 did not.

Results: There was a better recovery rate and GOS score for the patients who were given progesterone than for those in the control group in a 3-months follow-up period (50% vs. 21%); subgroup analysis showed a significant difference in the percentage of favorable outcome between the two groups with GCS of 5-8 (p=0.03).

Conclusion: The use of progesterone may significantly improve neurologic outcome of patients suffering severe TBI up to 3 months after injury, especially those with 5≤GCS≤8, providing a potential benefit to the treatment of acute severe TBI patients. Considering this drug had no significant side effects, so progesterone could be used in patients with severe TBI as a neuro-protective drug.

Keywords: Diffuse axonal injury; Glasgow coma scale; Neuro-protective agent; Progesterone; Traumatic brain injury.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Anti-Inflammatory Agents / therapeutic use*
  • Brain Injuries / drug therapy
  • Craniocerebral Trauma / drug therapy*
  • Craniocerebral Trauma / mortality
  • Craniocerebral Trauma / pathology
  • Diffuse Axonal Injury / drug therapy*
  • Diffuse Axonal Injury / mortality
  • Diffuse Axonal Injury / pathology
  • Glasgow Coma Scale
  • Glasgow Outcome Scale
  • Humans
  • Iran / epidemiology
  • Male
  • Middle Aged
  • Neuroprotective Agents / therapeutic use*
  • Persistent Vegetative State / epidemiology
  • Progesterone / therapeutic use*
  • Prognosis
  • Single-Blind Method
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Inflammatory Agents
  • Neuroprotective Agents
  • Progesterone