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You searched for +publisher:"Georgia State University" +contributor:("David Wright"). One record found.

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Georgia State University

1. Lunney, Michael. Effect of Progesterone Administration in Traumatic Subarachnoid Hemorrhage.

Degree: MPH, Public Health, 2015, Georgia State University

INTRODUCTION: Traumatic brain injury (TBI) is a major public health problem, causing approximately 52,000 deaths from 1.7 million injuries in the United States annually, with a combined direct and indirect economic cost estimated at $60-75 billion per year. Traumatic subarachnoid hemorrhage (tSAH), a subtype of closed head injury, has a high prevalence within TBI—evident in up to two-thirds of moderately and severely brain injured patients. tSAH is also associated with poor clinical outcomes; some research suggests mortality and unfavorable outcome rates are two-to-three times higher in patients with tSAH, based on brain imaging, compared to those without. To date, no pharmacological treatment has been conclusively shown to improve outcomes in humans for either moderate or severe TBI or for specific tSAH injury. The aim of this study was to assess whether the effect of PROG was substantially different in study TBI patients with evidence of tSAH on initial brain imaging compared to those that did not have evidence of tSAH. METHODS: ProTECT III clinical trial data was used for an exploratory, post hoc subgroup analysis to determine the effect of the hormone progesterone (PROG) on outcome. Study subjects with any abnormality on baseline brain imaging were included in the analysis and two subgroups, tSAH positive (+tSAH) and tSAH negative (–tSAH), were selected. The primary outcome evaluated was a favorable/unfavorable dichotomy derived from the 6-months post-injury Extended Glasgow Outcome Scale (GOSE) assessment, which evaluates both mortality and functional outcomes. Risk ratios (RRs) were calculated for the total sample and each of the two subgroups and used as statistical evidence for interaction between PROG and tSAH. RESULTS: All subjects from the original ProTECT III trial cohort (N=882) with no abnormalities found on baseline computed tomography (CT) image (n=125) or missing image (n=1) were excluded from this analysis. Subjects with one or more abnormalities noted on CT (+CT, n=756) were then divided into subgroups based on presence (n=582) or absence (n=174) of tSAH. Subjects with +tSAH were more severely injured than –tSAH (mean Rotterdam CT score 3.3 vs. 2.2; 3.1 overall) and had a lesser proportion of favorable outcomes (47.4% vs. 74.3%; 53.6% overall). Compared to placebo, patients treated with progesterone had marginally better likelihood of favorable outcomes (risk ratio among +tSAH 1.06, 95% confidence interval [CI], 0.89 to 1.26; and RR among –tSAH 1.02, 95% CI 0.85 to 1.22). A multivariable model, adjusted for baseline differences in treatment group covariates did not yield substantially different results for the effect of progesterone on favorable outcomes (+tSAH 1.07; 95% confidence interval [CI], 0.84 to 1.36, –tSAH 1.08; 95% CI 0.75 to 1.56, +CT 1.06; 95% CI 0.87 to 1.29). CONCLUSION: Our study demonstrated that progesterone did not result in different effects in patients with or without tSAH than those… Advisors/Committee Members: Ashli Owen-Smith, Matthew Magee, David Wright.

Subjects/Keywords: Traumatic brain injury; progesterone; traumatic subarachnoid hemorrhage

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APA (6th Edition):

Lunney, M. (2015). Effect of Progesterone Administration in Traumatic Subarachnoid Hemorrhage. (Thesis). Georgia State University. Retrieved from https://scholarworks.gsu.edu/iph_theses/407

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16th Edition):

Lunney, Michael. “Effect of Progesterone Administration in Traumatic Subarachnoid Hemorrhage.” 2015. Thesis, Georgia State University. Accessed December 14, 2019. https://scholarworks.gsu.edu/iph_theses/407.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7th Edition):

Lunney, Michael. “Effect of Progesterone Administration in Traumatic Subarachnoid Hemorrhage.” 2015. Web. 14 Dec 2019.

Vancouver:

Lunney M. Effect of Progesterone Administration in Traumatic Subarachnoid Hemorrhage. [Internet] [Thesis]. Georgia State University; 2015. [cited 2019 Dec 14]. Available from: https://scholarworks.gsu.edu/iph_theses/407.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Lunney M. Effect of Progesterone Administration in Traumatic Subarachnoid Hemorrhage. [Thesis]. Georgia State University; 2015. Available from: https://scholarworks.gsu.edu/iph_theses/407

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

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