Effect of progestrone in patients with severe traumatic brain injury Traumatic brain injury; progesterone administration; Glasgow Outcome Scale

Abstract

Background: Traumatic brain injury is a major public health concern, resulting in substantial mortality and long-term disability. So, it was important to search for novel therapeutic modalities that play an important role in reducing cerebral edema and had neuro- protective effect. A number of studies showed the feasibility, safety, and effectiveness of early parenteral administration of progesterone in acute severe traumatic brain injury patients compared with standard care.
Objective: The study aimed to assess the effect of the progesterone on the neurologic outcome in non-operable patients with acute severe traumatic brain injury.
Patients and Methods: This study was conducted on 50 patients presented with severe traumatic brain injury with GCS less than or equal to 8 after resuscitation and stabilization including both sexes. They were categorized into two groups according to applying the progesterone protocol. Patients were subjected to informed consent from next of kin, history taking, clinical neurological examination, routine laboratory and radiological investigations as needed and progesterone administration to patients in group 2which was given intramuscularly in dose of 1 mg/kg every12h for 7 consecutive days.
Results: Early parenteral administration of progesterone was associated with significant decrease in the mortality rate at day 28, significant improvement in Glasgow outcome scale of the patients by the end of day 28, significant improvement in level of consciousness of the patients (GCS), SOFA score, and CT brain Marshall scoring.
Conclusion: Progesterone administration in acute severe traumatic brain injury patients was associated with significant decrease in 28th day mortality, period of ICU stay, and mechanical ventilation days. Also, it was feasible and safe without noted complications.