Hypothermia for intracranial hypertension after traumatic brain injury

I decided to look at this again since it is still coming up in my news feeds. This research is incredibly flawed. The measurement endpoints of using the Extended Glasgow Outcome Scale are totally worthless. Nothing in them is objective at all except for the death category. These people need to be retrained in valid research techniques. Whatever conclusions they came up with can't be supported by their research. This research is not repeatable due to no objective starting or ending points. Once again stroke medical leadership needs to be fired.
http://www.mdlinx.com/internal-medicine/medical-news-article/2015/10/13/intracranial-hypertension/6359648/?
In patients with traumatic brain injury, hypothermia can reduce intracranial hypertension. The benefit of hypothermia on functional outcome is unclear. In patients with an intracranial pressure of more than 20 mm Hg after traumatic brain injury, therapeutic hypothermia plus standard care to reduce intracranial pressure did not result in outcomes better than those with standard care alone.

Methods

• Authors randomly assigned adults with an intracranial pressure of more than 20 mm Hg despite stage 1 treatments (including mechanical ventilation and sedation management) to standard care (control group) or hypothermia (32 to 35°C) plus standard care.
• In the control group, stage 2 treatments (e.g., osmotherapy) were added as needed to control intracranial pressure.
• In the hypothermia group, stage 2 treatments were added only if hypothermia failed to control intracranial pressure.
• In both groups, stage 3 treatments (barbiturates and decompressive craniectomy) were used if all stage 2 treatments failed to control intracranial pressure.
• The primary outcome was the score on the Extended Glasgow Outcome Scale (GOS–E; range, 1 to 8, with lower scores indicating a worse functional outcome) at 6 months.
• The treatment effect was estimated with ordinal logistic regression adjusted for prespecified prognostic factors and expressed as a common odds ratio (with an odds ratio <1.0 favoring hypothermia).

Results

• They enrolled 387 patients at 47 centers in 18 countries from November 2009 through October 2014, at which time recruitment was suspended owing to safety concerns.
• Stage 3 treatments were required to control intracranial pressure in 54% of the patients in the control group and in 44% of the patients in the hypothermia group.
• The adjusted common odds ratio for the GOS–E score was 1.53 (95% confidence interval, 1.02 to 2.30; P=0.04), indicating a worse outcome in the hypothermia group than in the control group.
• A favorable outcome (GOS–E score of 5 to 8, indicating moderate disability or good recovery) occurred in 26% of the patients in the hypothermia group and in 37% of the patients in the control group (P=0.03).