Sj. Gerndt et al., CONSEQUENCES OF HIGH-DOSE STEROID-THERAPY FOR ACUTE SPINAL-CORD INJURY, The journal of trauma, injury, infection, and critical care, 42(2), 1997, pp. 279-282
Objective: High-dose Solu-Medrol (Upjohn, Kalamazoo, Mich) therapy has
become standard care in the management of acute spinal cord injury (A
SCI), This study attempts to define the adverse effects that Solu-Medr
ol therapy has on these patients. Design: Retrospective review with hi
storical control. Material and Methods: From May 1990 to April 1994, a
ll 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 as
sociated ASCI who received no steroid therapy. Measurements and Main R
esults: Steroid therapy was associated with a 2.6-fold increase in the
incidence of pneumonia and an increase in ventilated and intensive ca
re days, However, it was associated with a decrease in duration of reh
abilitation 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 lo
ngterm outcome in patients with ASCIs.