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Injury Severity Score (ISS)
📖 Injury Severity Score (ISS)
- The ISS is an anatomical scoring system for patients with multiple injuries.
- Each injury is assigned an Abbreviated Injury Scale (AIS) score.
- Body regions considered: Head & Neck, Face, Chest, Abdomen, Extremities (including pelvis), and External.
- Only the most severe AIS score in each region is counted.
- The 3 worst regional scores are squared and summed → this gives the ISS.
- Range: 0–75. If any injury has AIS = 6 (unsurvivable), the ISS is automatically 75.
- Correlates linearly with mortality, morbidity, hospital stay, and overall severity.
Example Calculation
- Head/Neck: Cerebral contusion → AIS 3 → 3² = 9
- Chest: Flail chest → AIS 4 → 4² = 16
- Abdomen: Splenic rupture → AIS 5 → 5² = 25
- Total ISS = 9 + 16 + 25 = 50
Note: Different injury patterns may yield the same ISS. ISS is not a triage tool, as full injury descriptions are only available after full workup or surgery.
🩺 Abbreviated Injury Scale (AIS)
- An anatomical scoring system first introduced in 1969; updated in 1990.
- Ranks injuries by "threat to life," not functional outcome.
- Non-linear scale: difference between AIS 1→2 is not equal to AIS 4→5.
- Monitored by the Association for the Advancement of Automotive Medicine.
AIS Levels
- 1️⃣ Minor
- 2️⃣ Moderate
- 3️⃣ Serious
- 4️⃣ Severe
- 5️⃣ Critical
- 6️⃣ Unsurvivable
📚 Reference
- Baker SP et al. The Injury Severity Score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14:187–196.
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