THE INJURY SEVERITY SCORE (5) (ISS) IS A SCALAR (SINGLE NUMBER) MEASURE OF ANATOMIC INJURY, WIDELY USED IN AND AN IMPORTANT CONTRIBUTION TO TRAUMA RESEARCH. THE ISS IS THE SUM OF SQUARES OF THE HIGHEST ABBREVIATED INJURY SCALE (1-3) (AIS) GRADE IN EACH OF THE THREE MOST SEVERELY INJURED BODY REGIONS. THUS THE ISS IS A SUMMARY MEASURE OF TRAUMA TO SINGLE OR MULTIPLE BODY REGIONS. PER CENT MORTALITY FOR BLUNT INJURED PATIENTS HAS BEEN SHOWN TO BE RELATED TO ISS (BASED ON AIS-76) AND PATIENT AGE (4-6). PATIENTS USED TO ESTABLISH THOSE RELATIONSHIPS WERE TREATED IN 1961 AND 1967-1968. SIMILAR RELATIONSHIPS FOR PENETRATING INJURIES HAVE NOT BEEN PREPARED BECAUSE, UNTIL THE 1985 VERSION, THE AIS PROVIDED SEVERITY GRADES FOR BLUNT INJURIES ONLY. THE ISS IS FREQUENTLY USED TO ASSESS OR COMPARE THE INJURY SEVERITY OF PATIENT POPULATIONS (7, 10, 13, 16) AND AS THE ANATOMIC COMPONENT OF TRAUMA PATIENT CHARACTERIZATIONS USED IN EVALUATION OF CARE AND QUALITY ASSURANCE METHODS (8). THE AIS FIRST PUBLISHED IN 1971, WAS DEVELOPED TO CLASSIFY ANATOMIC INJURY FROM MOTOR VEHICLE-RELATED TRAUMA. IT HAS BEEN REVISED AND BROADENED IN SCOPE IN 1976, 1980, AND 1985. CHANGES IN INJURY CODING, TRAUMA CARE DELIVERY, AND CLINICAL MANAGEMENT MANDATE THE UPDATING OF RELATIONSHIPS BETWEEN SEVERITY MEASURES AND MORTALITY FROM WHICH CONCLUSIONS REGARDING PATIENT MANAGEMENT OR HEALTHCARE POLICY ISSUES MAY BE DRAWN. THE PRESENT STUDY USES THE MOST RECENT AIS VERSION (AIS-85) TO DERIVE RELATIONSHIPS BETWEEN MORTALITY RATE AND THE ISS FOR COMTEMPORARY PATIENTS WITH BLUNT OR PENETRATING INJURIES AND IDENTIFIES IMPORTANT PROPERTIES OF THE ISS WHICH SHOULD BE CONSIDERED WHEN THE MEASURE IS USED TO COMPARE CASE MIX SEVERITY IN DIFFERENT POPULATIONS.(Author/publisher).
Abstract