Progesterone Halves Mortality in Traumatic Brain Injury

Providing progesterone to adults with traumatic brain injury can cut their risk of near-term death in half and may improve chances for recovery in patients with less-severe injuries, according to a new study.

Researchers from Emory University (Atlanta, GA, USA) and Morehouse School of Medicine (Atlanta, GA, USA) conducted a three-year phase II pilot study named ProTECT (Progesterone for Traumatic brain injury - Experimental Clinical Treatment), involving 100 patients who presented at Grady Memorial Hospital (Atlanta, GA, USA) with a traumatic brain injury less than 11 hours old.

The patients all had blunt injuries and an initial Glasgow Coma Scale score ranging from 4-12. The majority of patients (71) were male, and 34 were black; mean patient age was 36. More than 80% of the injuries were due to car crashes or falls. The patients were randomized to receive either intravenous progesterone for three days (77) or placebo (23). Observers blinded to the type of therapy assessed the patients daily for the occurrence of adverse events and signs of recovery, and neurologic outcomes were assessed 30 days after the initial injury.

The investigators found that patients who received progesterone had a significantly lower risk of dying within 30 days compared with controls. There were no serious adverse events attributable to progesterone, and rates of adverse and serious adverse events were similar between the groups in all respects except for the mortality rate. The results were reported in the September 28, 2006, online edition of Annals of Emergency Medicine.

"We found encouraging evidence that progesterone is safe in the setting of traumatic brain injury, with no evidence of side effects or serious harmful events,” said lead author Dr. David Wright, M.D., of Emory University. "In addition, we found a 50% reduction in the rate of death in the progesterone-treated group. Furthermore, we found a significant improvement in the functional outcome and level of disability among patients who were enrolled with a moderate brain injury.”



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Emory University
Morehouse School of Medicine