A Study Of The Therapeutic Effects Of Progesterone In Patients With Traumatic Brain Injury: A Systematic Review And Meta-Analysis

Background and Objectives: Traumatic brain injury (TBI) is one of the main causes of death and disability in affected people. Progesterone, an endogenous steroid hormone, is known to have a function in the central nervous system. The aim of this study was to investigate the therapeutic effects of progesterone in patients with severe TBIs through systematic review and meta-analysis of randomized clinical trials. Methods: This systematic review and meta-analysis was conducted based on the preferred reporting items for systematic reviews and meta-analyses guidelines for systematic reviews. A systematic search was conducted at PubMed, EMBASE, Web of Science, and Scopus. The keywords, including "progesterone," "progestin," "traumatic brain damage," "TBI," "head injury," and "stroke" were searched. There was no time or language limit . Inclusion criteria were as follows: (a) study type: randomized controlled trial; (b) participants: patients with acute TBI; (c) intervention: progesterone; and (d) outcomes: favorable outcome based on mortality rate. Exclusion criteria were as follows: (a) study types: case reports, case reviews, retrospective study, and cohort studies and (b) control: positive control. The data were then collected and analyzed using randomized pooled analysis of risk ratio (RR) for mortality. Results: In the study, 721 articles were selected. Finally, 11 studies were analyzed and entered into meta-analysis. All studies are classified as high quality (with a score of more than 7) and therefore no studies were evaluated based on quality assessment. The result of the fixed pooled analysis of RR for mortality was 0.95 with a P value of 0.495. Conclusions: The results of the present study suggest that progesterone does not decrease the mortality rate despite the various data, suggesting the positive effects of progesterone on the treatment of TBIs.