Issue 40
March - April 2003

5,000 patients randomised


While US President George Bush, British prime minister Tony Blair and Spanish prime minister Jose Maria Aznar were meeting in the Azores to plan the war on Iraq, a truly international coalition meeting was taking place in Namur, Belgium, and one with a clear humanitarian aim - to ensure the success of the CRASH trial in the hope that its results will improve the care of the millions of people around the world who suffer a serious head injury every year.

The National Co-ordinators of the 19 top recruiting countries met over two days to plan how they will expand recruitment so that we double the number of patients recruited in the coming year. The meeting was opened by Monsieur Poncelet, President of Centre Hospitalier Regional de Namur, who welcomed the international delegates and offered a call for world peace. The meeting was a huge success and we thank Guy Mazairac and all his colleagues from the Service Des Urgences (SAMUR de Namur) for all their hard work and for making us all so welcome.

Representing their countries were Enrique Vergara, Argentina; Guy Mazairac, Belgium; Luis Nasi, Brazil; Miguel Arango, Colombia; Oscar Palma, Costa Rica; Caridad Soler, Cuba; Petr Svoboda, Czech Republic; Mario Izurieta, Ecuador; Hussein Khamis and Hesham Elsayed, Egypt; Nyoman Golden, Indonesia; Patrick Plunkett, Ireland; Laura Balica, Romania; Stefan Trenkler, Slovakia; Bennie Hartzenberg, South Africa; Rosario Amaya, Spain; Silke Ludwig, Switzerland; Surakrant Yutthakasemsunt, Thailand; Zouheir Jerbi, Tunisia and Rowley Cottingham UK. Each National Co-ordinator was happy to make firm commitments for the year ahead, not only to increase the recruitment rate in their hospitals to the maximum, but also to spread their own enthusiasm in their countries or their regions in order to recruit much needed new centres into the trial.


Welcome to all our Indian collaborators who have joined recently. We now have ten hospitals who have started recruiting or are about to start with several others in the process of applying for ethical review.

Four of the first collaborators to join the trial attended a meeting at the London Co-ordinating Centre in November 2002. The aim of the meeting was to determine the best approach to achieve high recruitment of patients in India and 100% complete data sets. The meeting was very successful with each collaborator identifying strategies that will ensure success at their hospital.

We currently have some difficulties with getting the trial materials through customs. We have applied to the Director General of Health Services for approval to import and will keep you informed of our progress.

Above with Ian Roberts and Haleema Shakur:
N K Venkataramana, Consultant Neurosurgeon, Manipal Institute for Neurological Disorders, Bangalore
Vijaya Ushanath Sethurayar, Senior Consultant Neurosurgeon, Meenakshi Mission Hospital & Research Centre, Tamil Nadu
Rajesh Bhagchandani, Consultant in Critical Care, Apex Hospital, Madhya Pradesh
Mazhar Husain, Head, Department of Neurosurgery, King George Medical College, Lucknow


Some of you have recently experienced problems trying to randomise patients by telephoning the Clinical Trials Unit. We are working with the Unit to resolve these problems but in the meantime, if telephone randomisation fails, please use the lowest available pack number and fax the patient entry form to us at +44 (0)20 7299 4663. This method should only be used as a last
resort in each case when the telephone call is unsuccessful.



Collaborators can now access CRASHNET from the CRASH website. With CRASHNET you can provide your EOF data more easily using the user-friendly interface. By sending your data electronically you will be helping to ensure your data are more efficiently processed into the trial database. You will also ensure that your data will be added to your existing data quicker and will be available for analysis.

You can use the ANALYSIS feature to make grouped analyses of your patients or the patients of the whole trial. Already collaborators are sending us their positive comments about this service. "It is remarkable how quickly I can produce some summary analyses of the CRASH Trial data - this was just what I needed for the presentation I gave in my hospital!"

You can now join the discussions taking place in the CRASHTALK forum. Guy Mazairac recently said: "I commit myself to do everything again and again, so I come back to Crashnet, and it works! First, we have to try harder. Second, we have to do Crash with pleasure, because it's a wonderful trial, and we all wait to know what to do with steroids for so so long. What we all have seen today seems to work better and better, so we all have to do it again!!!"

Why not log into CRASHNET today? CRASH Trial collaborators can obtain a login and password by sending an email to with the subject "CRASHNET account request".

to all the people listed below – Many thanks to you and your hard working teams!

1st patient - GREAT START

Flavio Nacul, Clínica São Vicente, Brazil
Jesus Quiñones, Hospital San Andres, Colombia
Roberto Gomez Pinedo, Hospital Timothy Britton, Colombia
Angel Lacerda, Hospital General de Morón, Cuba
Humberto Lezcano, Hospital General Universitario "Carlos Manuel de Cèspedes", Cuba
Tamara Gogichaishvili, Republican Hospital, Georgia

10 patients - WELL DONE

Mario Domínguez Perera, Hospital Universitario "Arnaldo Milián Castro", Cuba
Ehsan Sherafat Kazemzadeh, Fatemeh Zahra Hospital AND Social Security Hospital, Iran
José Luis Mejía González, Hospital General Regional Numero 1, Mexico
Edward O Komolafe, Obafemi Awolowo University Teaching Hospital, Nigeria
Adam Danil and Remus Iliescu, Sfantum Pantelimon Hospital, Romania
Abdelazeem Ali Eldawlatly, King Khalid University Hospital, Saudi Arabia
Jose Carlos Martin Rubi, Hospital Torrecárdenas, Spain
Urs Denzler, Kantonsspital Schaffhausen, Switzerland

50 patients - EXCELLENT

Marcus Green and Annie Kellins, Selly Oak Hospital, UK
Chen Xinkang, Zhongshan City People's Hospital, China

100 patients - EXCEPTIONAL
only 13 centres have more than 100 patients

Patrick Plunkett, St James's Hospital, Ireland

Maria de los Angeles Muñoz Sanchéz, Hospital Universitario Virgen del Rocio, Spain

Surakrant Yutthakasemsunt, Khon Kaen Regional Hospital, Thailand

New ethics approvals - hope to see your names up above soon

Virginia Rodriguez, Hospital Nacional Rosales, Colombia
Jimy Hurtado, Clínica Central, Ecuador
Esmaeel Fakharjan, Naghavi University Hospital, Iran
Giancarlo Andrioli, Ospedali Galliera, Italy
Alejandro Ibarra Orozco, Hospital General de Queretaro, Mexico – started recruitment
Miguel Angel Arruego Minguillón, Hospital Universitario de Girona Dr Josep Trueta, Spain - started recruitment

500 patients – UNIQUE

Petr Svoboda and Jiri Ochmann, Research Institute for Special Surgery and Trauma in
Czech Republic, have recruited 10% of all patients.
Thank you!

The paper based on the first 3,000 randomised patients has been published in Current Opinion in Critical Care with the title Update on progress in the international multicenter randomized controlled trial of corticosteroids after significant head injury (Medical Research Council CRASH Trial).
Reference: Current Opinion in Critical Care 2003;9(2):92-97

CRASH Co-ordinating Centre, LSHTM, 49-51 Bedford Square, LONDON WC1B 3DP

Tel +44(0)20 7299 4684 - Fax +44(0)20 7299 4663 - email CRASH@LSHTM.AC.UK


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