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ORIGINAL ARTICLE
Year : 2017  |  Volume : 4  |  Issue : 2  |  Page : 84-89

Impact of progesterone administration on outcome in patients with severe traumatic brain injury


Department of Critical Care Medicine, Faculty of Medicine, University of Alexandria, Alexandria, Egypt

Correspondence Address:
Amr Abouelela
Department of Critical Care Medicine, Faculty of Medicine, University of Alexandria, Alexandria
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/roaic.roaic_106_16

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Background No medication exists to halt the progression of secondary injuries in severe traumatic brain injury (TBI), but the variety of pathological events presents opportunities to find treatments that interfere with the damage processes. The effects of progesterone on the reproductive and endocrine systems are well known, but a growing body of evidence indicates that the hormone also exerts neuroprotective effects on the central nervous system by decreasing overall cerebral edema, protecting and rebuilding the blood–brain barrier, downregulating the inflammatory cascade, and limiting cellular necrosis and apoptosis. Aim The aim of this study was to evaluate the effect of progesterone administration on improvement in outcomes of patients with TBI as measured by the Glasgow Outcome Scale. Patients and methods The present study was a prospective, randomized trial. A total of 100 patients with severe TBI were enrolled for the present study. The selected patients were categorized at random into two equal groups − the control group and the progesterone group. In the control group, patients were given conventional therapy. The progesterone group was given 1 mg/kg progesterone by intramuscular injection within 8 h of admission and then every 12 h for 5 consecutive days in addition to the conventional therapy. The neurological outcome after 30 days was evaluated using the Glasgow Outcome Scale score as well as duration of ICU stay. Results In the progesterone group, 33/50 (66%) patients had favorable outcomes and 17/50 (34%) had unfavorable outcomes, whereas in the control group 23/50 (46%) patients had favorable outcomes and 27/50 (54%) had unfavorable outcomes (P=0.072). Length of ICU stay had a mean value of 10.88±7.98 days in the progesterone group versus 19.96±10.36 days in the control group (P<0.001). Conclusion No significant difference in outcome between the two groups was observed, but there was a significant decrease in ICU length of stay in the progesterone group.


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