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J Trauma. 1997 Feb;42(2):279-84.

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

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1
Division of Trauma, Burn, and Emergency Surgery, University of Michigan, Ann Arbor, USA.

Abstract

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.

MATERIALS 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.

PMID:
9042882
[Indexed for MEDLINE]
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