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Dexamethasone therapy poses high risk for patients with chronic subdural hematoma

Journal
The New England Journal of Medicine
Reuters Health - 16/12/2020 - Treating chronic subdural hematoma with dexamethasone may do more harm than good, producing less favorable outcomes and more side effects than placebo, according to a new U.K. study that randomized 748 patients. Whether the treatment is useful "has been an unanswered question for decades," chief author Dr. Peter Hutchinson of the University of Cambridge told Reuters Health by phone. "I would hope and anticipate that doctors will stop using it. This has certainly changed our practice in Cambridge," he said. Nearly all of the participants had surgery to remove the hematoma during the index hospitalization. Glucocorticoid therapy did significantly lower the need for repeat operations, but the recurrence rate was low -- 7.1% with placebo versus 1.7% among the dexamethasone recipients. Dr. Hutchinson's team assessed the treatment based on a primary outcome of 0 to 3 on the 7-point modified Rankin Scale, where a score of 6 indic...


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