Effect of a Combinational therapy of Erythropoietin, Pentoxifylline, and Vitamin D on the Glasgow Outcome Scale in Patients with Traumatic Brain Injury

Background: Diffuse axonal injury (DAI) is the most prevalent nerve lesion in brain trauma. Given the known effects of erythropoietin and pentoxifylline on the reduction of cell death following hypoxia. Objectives: The current study assessed the possible effects of a combination of erythropoietin, pentoxifylline, and vitamin D on patients' consciousness level. Methods: The present research is a double-blind clinical trial with parallel groups addressing 64 DAI patients (average age: 26.5). The intervention group included 32 patients who, apart from the routine treatment, received a combination of erythropoietin, pentoxifylline, and vitamin D3. The control group also encompassed 32 patients who only received routine treatment. The effects of the interventions were assessed based on Glasgow Coma Scale (GCS), Glasgow Outcome Scale (GOS) scores, and hospitalization duration. Results: The findings of the current research revealed that the GCS scores of the supplement (13.6±0.5) and control groups (12.4±1.6) were significantly different (P=0.043), being higher in the supplement group. The supplement group gained a higher GOS score compared to the controls (4.62±0.15 and 3.8±0.16, respectively, P=0.045). Moreover, a significant difference was observed in the hospitalization duration of the supplement (26.5±5.2) and control groups (21.4±3.2) (P=0.020). Nonetheless, the analysis of the extubation time and blood pressure of the two groups exhibited no substantial difference. Conclusion: In this study, GCS and GOS improved after supplementation. The patients in the supplement group displayed a significantly shorter hospitalization duration. No significant difference was, however, detected when the tube was removed.