The outcome of patients with severe head injuries treated with amantadine sulphate

Summary.

Objective. To compare our pilot therapeutic results of patients with severe head injury treated either with standard therapy alone or with standard therapy plus amantadine sulphate.

Design. Retrospective pilot study.

Setting. Intensive Care Unit (ICU), University Hospital.

Patients. All patients with severe head injury (GCS < 8) admitted to the ICU between January 1, 1999 and December 31, 2001. The patients were divided into two groups based on the fact, whether they did or did not receive amantadine sulphate included in standard therapy. Group 1 consisted of 41 patients of average age 42.12 ± 16.8 years, of them 35 were males and 6 females. Group 2 included 33 patients of average age 43.91 ± 18.45 years consisting of the 30 males and 3 females.

Intervention. Both groups were treated with the standard therapy of severe head injury accepted in our institution. In addition, group 1 patients received amantadine sulphate in a dose of 200 mg i.v. twice daily for 3 days, starting on day 3 of hospitalisation. The reason for amantadin sulphate administration was persistent comatos condition.

Measurements and results. Glasgow Coma Scale in patients on admission (after resuscitation) and on discharge from the ICU and mortality rate were compared. In the group 1 the average income GCS was 4.47 ± 2.26 and the average outcome GCS was 9.76 ± 3.95. In the group 2 the average income GCS was 4.70 ± 2.14 and the average outcome GCS was 5.73 ± 3.57. In the amantadine sulphate group two patients out of 33 died (6.06%). There were 17 deaths (51.51%) out of 33 patients in the second control group.

Conclusion. In the group of patients with severe brain injuries treated with standard therapy plus amantadine sulphate the outcome GCS was higher and the case fatality rate lower than in the group treated with standard therapy alone.