Evidence map›Paper›PMID 33546038›Full record

ArticleMedicine2021

Dexamethasone for the treatment of traumatic brain injured patients with brain contusions and pericontusional edema: Study protocol for a prospective, randomized and double blind trial.

Jon Pérez-Bárcena, Ana María Castaño-León, Alfonso Lagares Gómez-Abascal, Jesús Abelardo Barea-Mendoza, Blanca Navarro Maín, Jaume Pomar Pons, Leonor Del Mar Periañez Párraga, Javier Ibáñez Domínguez, Mario Chico-Fernández, Juan Antonio Llompart-Pou and 2 more

Registry-linked trialOpen access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in Medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04303065 (Dexamethasone for the Treatment of Traumatic Brain Injured Patients With Brain Contusions and Pericontusional Edema), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04303065 phase3terminatednot on this map

Dexamethasone for the Treatment of Traumatic Brain Injured Patients With Brain Contusions and Pericontusional Edema: Study Protocol for a Prospective, Randomized and Double Blind Trial.

TypeinterventionalSponsorJon Pérez BárcenaRan2020 to 2025Enrolled600ConditionsTraumatic Brain Injury, Cerebral Edema, Head Injury TraumaArmsDexamethasone Oral, Placebo oral tablet
3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 3 countries.

Jon Pérez-BárcenaIntensive Care Unit, Hospital Universitari Son Espases, Palma de Mallorca.ORCID 0000-0003-4147-8636
Ana María Castaño-LeónDepartment of Neurosurgery, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Universidad Complutense de Madrid.
Alfonso Lagares Gómez-AbascalDepartment of Neurosurgery, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Universidad Complutense de Madrid.
Jesús Abelardo Barea-MendozaIntensive Care Unit, Hospital Universitario 12 de Octubre, Madrid.
Blanca Navarro MaínDepartment of Neurosurgery, Hospital Universitario 12 de Octubre, Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Universidad Complutense de Madrid.
Jaume Pomar PonsNeuropsychology and Cognition Research Group, Research Institute on Health IDISBA & IUNICS-UIB, Palma de Mallorca.
Leonor Del Mar Periañez PárragaPhamacy Department, Hospital Universitari Son Espases.
Javier Ibáñez DomínguezDepartment of Neurosurgery, Hospital Universitari Son Espases.
Mario Chico-FernándezIntensive Care Unit, Hospital Universitario 12 de Octubre, Madrid.
Juan Antonio Llompart-PouIntensive Care Unit, Hospital Universitari Son Espases, Palma de Mallorca.
Guillem Frontera JuanResearch Institute on Health IDISBA, Hospital Universitari Son Espases, Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma de Mallorca.
DEXCON TBI trial collaborators
Apple (Israel) · ILUniversidad Complutense de Madrid · ESHospital Universitario Son Espases · ES

Funding

Sociedad Española Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) no
6 · The paper itself

Abstract

backgroundTraumatic brain injury (TBI) constitutes a leading cause of death and disability. Patients with TBI and cerebral contusions developing pericontusional edema are occasionally given dexamethasone on the belief that this edema is similar to that of tumors, in which the beneficial effect of dexamethasone has been demonstrated.

methodsThe DEXCON TBI trial is a multicenter, pragmatic, randomized, triple-blind, placebo controlled trial to quantify the effects of dexamethasone on the prognosis of TBI patients with brain contusions and pericontusional edema. Adult patients who fulfill the elegibility criteria will be randomized to dexamethasone/placebo in a short and descending course: 4 mg/6 h (2 days); 4 mg/8 hours (2 days); 2 mg/6 hours (2 days); 2 mg/8 hours (2 days); 1 mg/8 hours (2 days); 1 mg/12 hours (2 days). The primary outcome is the Glasgow Scale Outcome Extended (GOSE) performed 1 month and 6 months after TBI. Secondary outcomes are: number of episodes of neurological deterioration; symptoms associated with TBI; adverse events; volume of pericontusional edema before and after 12 days of treatment; results of the neuropsychological tests one month and 6 months after TBI. The main analysis will be on an "intention-to-treat" basis. Logistic regression will estimate the effect of dexamethasone/placebo on GOSE at one month and at 6 months, dichotomized in unfavorable outcome (GOSE 1-6) and favorable outcome (GOSE 7-8). Efficacy will also be analyzed using the 'sliding dichotomy'. An interim and safety analysis will be performed including patients recruited during the first year to calculate the conditional power. A study with 600 patients would have 80% power (2 sided alpha = 5%) to detect a 12% absolute increase (from 50% to 62%) in good recovery. DISCUSSION: This is a confirmative trial to elucidate the therapeutic efficacy of dexamethasone in a very specific group of TBI patients: patients with brain contusions and pericontusional edema. This trial could become an important milestone for TBI patients as nowadays there is no effective treatment in this type of patients.

trial registrationeudraCT: 2019-004038-41; Clinical Trials.gov: NCT04303065.

Indexed as

Anti-Inflammatory AgentsBrain ContusionBrain EdemaDexamethasoneDouble-Blind MethodHumansOutcome Assessment, Health CarePragmatic Clinical Trials as TopicProspective StudiesRandomized Controlled Trials as TopicAnti-Inflammatory AgentsDexamethasone

Identifiers

PMID33546038
PMCPMC7837989
OpenAlexW3122960868

What OpenQuestion holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.