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Injury Severity Score (ISS)

Calculators  Multiple body systems
Injury Severity Score (ISS) indicates the severity of the traumatic injury of six body systems.
Head and neck worst injury?
No injury 0
Minor 1
Moderate 2
Serious 3
Severe 4
Critical 5
Unsurvivable 6
Face worst injury?
No injury 0
Minor 1
Moderate 2
Serious 3
Severe 4
Critical 5
Unsurvivable 6
Chest worst injury?
No injury 0
Minor 1
Moderate 2
Serious 3
Severe 4
Critical 5
Unsurvivable 6
Abdomen worst injury?
No injury 0
Minor 1
Moderate 2
Serious 3
Severe 4
Critical 5
Unsurvivable 6
Extremity (including pelvis) worst injury?
No injury 0
Minor 1
Moderate 2
Serious 3
Severe 4
Critical 5
Unsurvivable 6
External worst injury?
No injury 0
Minor 1
Moderate 2
Serious 3
Severe 4
Critical 5
Unsurvivable 6
Result:

Background

Measured Factor
ISS score
Measured Factor Disease
  • Traumatic injury
Measured Factor Detail
Injury Severity Score (ISS) indicates the severity of the traumatic injury of six body systems i.e. head and neck injury, face injury, chest injury, abdomen injury, extremity including pelvis injury, and external injury. All these body system score as 0- no injury, 1- minor, 2- moderate, 3- serious, 4- severe, 5- critical, 6-unsurvival.
Speciality
Multi-Speciality
Body System
Multiple body systems
Measured Factor High Impact
  • Score > or = 1 indicates severity of the traumatic injury
  • Score 75 indicates major trauma sustained

Result Interpretation

Ranges Ranges
  • Critical High: Score >=1
  • Normal: Score 0
  • Normal Adult Male: Score 0
  • Normal Adult Female: Score 0
Result High Conditions
  • Traumatic injury
Test Limitations
ISS fails in examining specific injury severity dimensions in patients.
References: 2

Studies

Study Validation 1
The present study aimed to describe the validation of injury severity score for the gunshot wounds. Off 875 subjects, 118 have died as well as 115 have died on arrival. In comparison to Baker’s study included 2128 subjects from road traffic accidents, 248 died, with 111 dead on arrival. A total of 2195 gunshot wound victims reported with 92.5% were under the age of 50 years, amongst them the 474 have died, thus demonstrating that in terms of mortality, the present study contained a representative sample. The study concluded that the concept of an injury severity score is very useful.
References: 3
Study Validation 2
The purpose of this study is to validate the Injury Severity Score (ISS) in men, women and in three different race/ethnic groups to determine the injury severity as well as predicts mortality. Off 872,102 subjects, the total 763,549 patients participated in the gender analysis. ROC in Whites was 0.8617, Blacks were 0.85,86 and among Hispanics were 0.8869; respectively, Hispanics have a statistically significant higher ROC than others. The ROC curves were also remarkably higher amongst females than in males. The study concluded that the ISS has an excellent discriminatory ability amongst all populations as indicated by the high ROCs.
References: 4
Study Validation 3
The study aimed to investigate the efficacy of Injury Severity Score (ISS) vs. ICD-derived Injury Severity Score (ICISS) in a patient population treated in a designated Hong Kong trauma centre. Off 1168 cases for ICISS calculation, of mean age was 45.9 years; respectively, multivariate logistic regression analysis with ISS, age, RTS, mechanism of injury, inclusive and exclusive ICISS values were found to be independent predictors of mortality. The AUC values for ISS, inclusive ICISS and exclusive ICISS were 0.868, 0.851 and 0.838. The study concluded that the empirically derived ICISS performed as well as the consensus derived ISS have no statistical differences between their respective area under the ROC curves.
References: 5
Study Additional 1
The study aimed to evaluate the mortality, morbidity and major trauma registry by using the Injury Severity Score (ISS). There have been significant developments in both the Abbreviated Injury Scale underlying the ISS, and trauma management techniques, both in the preventive and acute-care phases of trauma management. Off 8,177 trauma subjects, 566 patients had a greater ISS than 11; respectively, optimum sensitivity and specificity values for the two threshold determination methods described the simultaneous maximum sensitivity and specificity as well as the ISS thresholds returned. The study concluded that the re-evaluation could also occur more locally within existing trauma registries, whether paediatric or population-based.
References: 6
Study Additional 2
The purpose of this study is to determine the severity of an injury. Among 1333 road accident patients, the ISS, together with age, gives a reasonably good prognostic index of mortality. It also showed the relationship of ISS to a period of survival, treatment time and disability in a series of road traffic accident cases. The study concluded that  ATS ratings by cubes rather than squares has been suggested but this has not yet been fully assessed, so something on these lines will be useful in the many fields where the severity of injury needs to be measured.
References: 7
Study Additional 3
The aim of this study was to revaluate Injury Severity Score for multiple injuries and the similarity of its relation to mortality and age. Cases from 1333 road traffic accidents were taken. The I.S.S. values were then related to the observed mortality, time to death, hospital in-patient treatment times and disability. Probit analysis was used to linearise the mortality data in separate age groups. The disabilities were categorized as very severe, severe, moderate, slight and nil. I.S.S scores were given to the patients in range from 0-75. The I.S.S. values of this series of road traffic accidents show relationships to clinical severity as measured by mortality, time to death, duration of hospital treatment and incidence of disability. This study concluded that I.S.S. index is evidently quite an efficient measure of severity; it may still be open to further improvement.
References: 8

References

  1. Baker SP, O'neill B, Haddon W, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974;14(3):187-96.
  2. Palmer C. Major trauma and the injury severity score--where should we set the bar?Annu Proc Assoc Adv Automot Med. 2007;51:13-29.
  3. Beverland DE, Rutherford WH. An assessment of the validity of the injury severity score when applied to gunshot wounds. Injury. 1983;15(1):19-22.
  4. Bolorunduro OB, Villegas C, Oyetunji TA, Haut ER, Stevens KA, Chang DC, et al. Validating the Injury Severity Score (ISS) in different populations: ISS predicts mortality better among Hispanics and females. J Surg Res. 2011;166(1):40-4.
  5. Wong SS, Leung GK. Injury Severity Score (ISS) vs. ICD-derived Injury Severity Score (ICISS) in a patient population treated in a designated Hong Kong trauma centre. Mcgill J Med. 2008;11(1):9-13.
  6. Palmer C. Major trauma and the injury severity score--where should we set the bar? Annu Proc Assoc Adv Automot Med. 2007;51:13-29.
  7. Bull JP. Measures of severity of injury. Injury. 1978 Feb 1;9(3):184-7.
  8. Bull JP. The injury severity score of road traffic casualties in relation to mortality, time of death, hospital treatment time and disability. Accident Analysis & Prevention. 1975 Dec 1;7(4):249-55.