Modified injury severity scale and concurrent steroid therapy: independent correlates of negative nitrogen balance in pediatric trauma.

Twelve well-nourished children with multiple trauma were separately grouped by the presence or absence of a head injury and associated steroid treatment. They were studied to determine the impact of the severity of overall injury (measured by MISS), neurologic injury (measured by GCS), and steroid administration on total urinary nitrogen excretion. All six children with significant head injury received steroids. Nitrogen loss was higher in more severely injured patients. Severity of overall injury was similar in the steroid and nonsteroid treated groups. The nitrogen loss in head-injured patients treated with steroids was significantly greater (P less than 0.001) than in the nonsteroid-treated patients.