BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet Test: Injury Severity Scale, Injury Severity Score (ISS) Year: 1974 Domain: Biological Assessment Tool Category: Physical Functioning/ADLs Variations/Translations: Abbreviated Injury Score (AIS), New Injury Severity Score, Minor Injury and Severity Scale Setting: Clinical, research Method of Delivery: Audit of trauma records Description: The ISS is an established medical score used to assess trauma severity. It correlates with morbidity, mortality, and hospitalization time after trauma. The ISS is derived from the abbreviated injury scale (AIS). The ISS is an ordinal scale with a range from 1-75, and is computed as the sum of the squares of the highest AIS scores for the three most severely injured body regions. The ISS was developed originally to predict morality. Scoring/Interpretation: The Injury Severity Score (ISS) is an anatomical scoring system that provides an overall score for patients with multiple injuries. Each injury is assigned an AIS and is allocated to one of six body regions (Head, Face, Chest, Abdomen, Extremities (including Pelvis), External). Only the highest AIS score in each body region is used. The 3 most severely injured body regions have their score squared and added together to produce the ISS score. The ISS score takes values from 0 to 75. If an injury is assigned an AIS of 6 (unsurvivable injury), the ISS score is automatically assigned to 75. The ISS score is virtually the only anatomical scoring system in use and correlates linearly with mortality, morbidity, hospital stay and other measures of severity. Its weaknesses are that any error in AIS scoring increases the ISS error. Many different injury patterns can yield the same ISS score and injuries to different body regions are not weighted. Also, as a full description of patient injuries is not known prior to full investigation & operation, the ISS (along with other anatomical scoring systems) is not useful as a triage tool. ISS over 20 is a poor prognosis. Time to Administer: Varies, depends on the person completing the audit Availability: Contact author Dr. Mark Stevenson, Road Accident Prevention Research Unit Department of Public Health, University of Western Australia, Nedlands, WA 6907, Australia mark@health.curtin.edu.au Software: N/A Website: N/A Quantitative/Qualitative: Quantitative Validity (Quantitative): N/A Reliability (Quantitative): N/A References: Stevenson, M., Segui-Gomez, M., Lescohier, I., Di Scala, C., & McDonald-Smith, G. (2001). An overview of the injury severity score and the new injury severity score. Injury Prevention, 7, 10-13. Baker, S.P., O’Neil, B., Haddon W, et al. (1974). The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. Journal of Trauma, 14, 187-96. Brenneman, F.D., Boulanger, B.R., Mclellan, B.C., et al. (1998). Measuring injury severity: time for a change? Journal of Trauma, 44, 580-2. Glancy, K.E., Glancy, C.J., Lucke, J.F., et al. (1992). A study of recovery in trauma patients. Journal of Trauma, 33, 602-9. Osler, T., Baker, S., & Long, W. (1997). A modification of the injury severity score that both improves accuracy and simplifies scoring. Journal of Trauma, 41, 922-926. Comments: Used primarily for research purposes. The psychometric properties have not been examined in great detail, but the scale is used in several hospitals.