The effect of post-injury erythropoietin administration on mortality and Glasgow outcome scales of patients with traumatic brain injury: A metaanalysis.

Abstract

Objectives: To determine whether post-injury treatment with erythropoietin provides lower mortality rates and improved Glasgow Outcome Scales in patients with traumatic brain injury (TBI). Methods: Randomized controlled trials (RCTs) were searched through PUBMED, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and www.googlescholar.com. The reference list of a systematic review was also searched. Results: Four RCTs comparing erythropoietin and placebo, regardless of dose, dosing regimen, and route of administration were reviewed. Data analysis showed that mortality rates for the erythropoietin group (OR 0.63, CI 0.43, 0.93) was significantly lower compared to the placebo group. However, there was no significant difference in the Glasgow Outcome Scales of TBI patients given erythropoietin compared to placebo. Conclusion: Post-injury treatment with erythropoietin, regardless of dose, dosing regimen, and route of administration yielded lower mortality rates in patients with traumatic brain injury but had no significant effect on Glasgow Outcome Scales. It is recommended that further large scale randomized controlled trials be performed in order to fully establish the safety and support the efficacy of erythropoietin administration in patients with traumatic brain injury.