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18
11%
400/3535
25
7%
238/3535
33
8%
296/3535
41
68%
2421/3535
48
4%
148/3535
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This patients Injury Severity Score (ISS) is 41. In this patient, the highest AIS scores were from the head (AIS=4), abdomen (AIS=4) and pelvis (AIS=3). Therefore, the calculation for the ISS score was 4^2 + 4^2 + 3^2 = 41. The ISS score is calculated as the sum of the square values from the highest Abbreviated Injury Score [AIS] scores in the three most severely injured ISS body regions. ISS scores range from 1 to 75. A single score of 6 on any AIS region results in automatic score of 75. ISS scores > 15 are associated with mortality of 10%. Poole et al. found that the AIS and ISS appropriately reflect the impact of extraskeletal injuries in patients with femur fractures, but they do not adequately reflect the increased morbidity associated with multiple lower extremity fractures. Balogh et al. aimed to compare the scoring efficacy of the injury severity score (ISS) and the new injury severity score (NISS) in predicting post-injury outcomes. They found that multiple orthopaedic injuries, as used in the NISS system, had a significantly greater impact on reported poor post-injury outcomes. They suggest that NISS should replace the traditional ISS when grading trauma related outcomes. Illustration A shows a table of the various ways to score injury severity in trauma patients. Incorrect Answers: Answers 1,2,3,5: ISS = A^2 + B^2 + C^2, where A, B, C are the AIS scores of the three most severely injured ISS body regions. The only correct answer is ISS=41.
2.4
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