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Consequences of high-dose steroid therapy for acute spinal cord injury

Journal of Trauma - Injury, Infection and Critical Care, ISSN: 1529-8809, Vol: 42, Issue: 2, Page: 279-284
1997
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Article Description

Objective: High-dose Solu-Medrol (Upjohn, Kalamazoo, Mich) therapy has become standard care in the management of acute spinal cord injury (ASCI). This study attempts to define the adverse effects that Solu-Medrol therapy has on these patients. Design: Retrospective review with historical control. Material and Methods: From May 1990 to April 1994, all patients with ASCI admitted within 8 hours of injury received high-dose Solu-Medrol per the National Acute Spinal Injury Study (NASCIS-2) protocol. Their demographic and outcome parameters were compared with those of a group admitted from March 1986 to December 1993 with an associated ASCI who received no steroid therapy. Measurements and Main Results: Steroid therapy was associated with a 2.6-fold increase in the incidence of pneumonia and an increase in ventilated and intensive care days. However, it was associated with a decrease in duration of rehabilitation and had no significant impact on other outcome parameters, including mortality. Conclusions: Although the NASCIS-2 protocol may promote early infectious complications, it has no adverse impact on long- term outcome in patients with ASCIs.

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