Injury Severity Score

The Injury Severity Score (ISS) is an established medical score to assess trauma severity.^[1]^[2] It correlates with mortality, morbidity and hospitalization time after trauma. It is used to define the term major trauma. A major trauma (or polytrauma) is defined as the Injury Severity Score being greater than 15.^[2] The AIS Committee of the Association for the Advancement of Automotive Medicine (AAAM) designed and improves upon the scale.

Abbreviated Injury Scale (AIS)

The Abbreviated Injury Scale (AIS) is an anatomically based consensus-derived global severity scoring system that classifies each injury in every body region according to its relative severity on a six-point ordinal scale:

Minor
Moderate
Serious
Severe
Critical
Maximal (currently untreatable).

There are nine AIS chapters corresponding to nine body regions:

Head
Face
Neck
Thorax
Abdomen
Spine
Upper Extremity
Lower Extremity
External and other.

ISS Definition

The ISS is based (see below) upon the Abbreviated Injury Scale (AIS). To calculate an ISS for an injured person, the body is divided into six ISS body regions. These body regions are:

Head or neck - including cervical spine
Face - including the facial skeleton, nose, mouth, eyes and ears
Chest - thoracic spine and diaphragm
Abdomen or pelvic contents - abdominal organs and lumbar spine
Extremities or pelvic girdle - pelvic skeleton
External

To calculate an ISS, take the highest AIS severity code in each of the three most severely injured ISS body regions, square each AIS code and add the three squared numbers for an ISS ( $ISS = A 2 + B 2 + C 2$ where A, B, C are the AIS scores of the three most injured ISS body regions). The ISS scores ranges from 1 to 75 (i.e. AIS scores of 5 for each category). If any of the three scores is a 6, the score is automatically set at 75. Since a score of 6 ("unsurvivable") indicates the futility of further medical care in preserving life, this may mean a cessation of further care in triage for a patient with a score of 6 in any category.^[3]

References

↑ Baker SP, O'Neill B, Haddon W, Long WB (1974). "The Injury Severity Score: a method for describing patients with multiple injuries and evaluating emergency care". The Journal of Trauma. Lippincott Williams & Wilkins. 14 (3): 187–196. doi:10.1097/00005373-197403000-00001. PMID 4814394.
1 2 Copes, W.S.; H.R. Champion; W.J. Sacco; M.M. Lawnick; S.L. Keast; L.W. Bain (1988). "The Injury Severity Score revisited". The Journal of Trauma. Lippincott Williams & Wilkins. 28 (1): 69–77. doi:10.1097/00005373-198801000-00010. PMID 3123707.
↑ Trauma.org website. http://www.trauma.org/index.php/main/article/383/ Accessed Nov. 18, 2009

Trauma

Principles

Assessment

Clinical prediction rules	Revised Trauma Score Injury Severity Score Abbreviated Injury Scale NACA score

Investigations	Diagnostic peritoneal lavage Focused assessment with sonography for trauma

Management

Principles	Advanced trauma life support Trauma surgery Trauma center Trauma team Damage control surgery Early appropriate care

Procedures	Resuscitative thoracotomy

Pathophysiology

Injury	MSK Bone fracture Joint dislocation Degloving Soft tissue injury Resp Flail chest Pneumothorax Hemothorax Diaphragmatic rupture Pulmonary contusion Cardio Internal bleeding Thoracic aorta injury Cardiac tamponade GI Blunt kidney trauma Ruptured spleen Neuro Penetrating head injury Traumatic brain injury Intracranial hemorrhage

Mechanism	Blast injury Blunt trauma Burn Penetrating trauma Crush injury Stab wound Ballistic trauma Electrocution

Region	Abdominal trauma Chest trauma Facial trauma Head injury Spinal cord injury

Demographic	Geriatric trauma Pediatric trauma

Complications

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