Skrifvars et al. (2017)

Australia

Secondary Analysis to RCT

PEDro=9

N=606

Population: TBI.

Intervention: Patients received either weekly doses of 40,000IU of subcutaneous epoetin alfa (EPO) or placebo for a maximum of 3 doses or until discharge from the ICU.

Outcome Measure: Subgroup Analysis.

1.         Most TBI deaths were from cerebral causes in the first 2wk and were related to withdrawal of care.

2.         There was a difference in EPO effect in patients who had undergone a neurosurgical procedure prior to randomization compared with those who had not. EPO decreased mortality more in the group who had not undergone a previous neurosurgical operation (p=0.01) compared with those who had (p=0.37).

Li et al. (2016)

China & Australia

RCT

PEDro=9

N_initial=159  N_final=146

Population: Severe TBI; Treatment Group (n=75): Mean Age=43.4 yr; Gender: Male=49, Female=26; Time Post Injury≤6h; Mean GCS=6.8. Control Group (n=71): Mean Age=41.1 yr; Gender: Male=41, Female=30; Time Post Injury≤6h; Mean GCS=7.1.

Intervention: Patients received 100U/kg subcutaneous injections of recombinant human erythropoietin on days 1, 3, 6, 9 and 12 following TBI. The control group received the same volumes of saline injections on the same days post injury.

Outcome Measures: Biochemical and Physiological Parameters, Glasgow Outcome Scale (GOS).

1.         There were no significant differences between groups in blood pressure, hemoglobin levels, infection rates, or thromboembolic events 3mo after treatment. On day 7, the treatment group had significantly lower serum NSE and S-100β protein levels (p<0.05).

2.         At 3 mo follow-up, patients in the treatment group had better recovery based on itemized GOS analysis. Specifically, the treatment group had significantly more individuals in itemized GOS categories of good recovery and moderate disability, and significantly fewer individuals in the categories of severe disability and vegetative state (all p<0.05).