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A Glimpse into the World of Severe injury scoring

A Glimpse into the World of Severe injury scoring. Dia Gainor, NASEMSO. State Level Injury Record Sources. National EMS System Information System (NEMSIS) Version 3.0 Compliant Out-of-Hospital Records Emergency Department Discharge Databases Hospital Discharge Databases Trauma Registries.

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A Glimpse into the World of Severe injury scoring

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  1. A Glimpse into the World of Severe injury scoring Dia Gainor, NASEMSO

  2. State Level Injury Record Sources • National EMS System Information System (NEMSIS) Version 3.0 Compliant Out-of-Hospital Records • Emergency Department Discharge Databases • Hospital Discharge Databases • Trauma Registries

  3. Two Accepted Categoriesof Methods • Physiological scoring systems • Glasgow coma scale • Trauma score • Revised trauma score • TRISS methodology • Anatomical scoring systems • Abbreviated injury score • Injury severity score • ICD-9 Injury Severity Score

  4. First, the “Abbreviated Injury Scale” • Calibrated by the Association for the Advancement of Automotive Medicine • First developed in 1969 • Anatomically based • Consensus derived • Updated every five years • Has been adopted by numerous other countries

  5. Each injury ranked on aScale of 1-6 representing“threat to life” • 1 = Minor • 2 = Moderate • 3 = Serious • 4 = Severe • 5 = Critical • 6 = Maximum (Untreatable)

  6. Thank Heaven for Surgeons

  7. Each Injury Allocated by Body Region withSeverity Ranking • Head/neck • Face • Chest • Abdomen • Extremity • External (skin)

  8. AIS Assignment • ONLY highest AIS number in each body area is used • 3 most severely injured body region scores squared • 3 squared scores added together • = Injury Severity Score

  9. (highest region score)2+(second highest region score)2+ (third highest region score)2=Injury severity score

  10. Injury Severity Score Range 1-75 • If injury is assigned a 6 (unsurvivable), ISS automatically = 75 • Score Reflective of Injury Severity • 1 - 9 Minor • 10 - 15 Moderate • 16 - 24 Moderate/Severe • ≥ 25 Severe/Critical

  11. ISS Weaknesses: • Many different injury patterns yield same ISS score • Errors of AIS scoring = errors of ISS • Injuries to different body regions are not weighted • Limits the number of contributing injuries to 3 • Can’t account for multiple injuries to the same body region

  12. ISS Strengths • Anatomical scoring system for patients with multiple injuries • ISS score correlates with mortality, morbidity & hospital stay • Bivariate correlation of mortality % with ISS and age

  13. ANY QUESTIONS I CAN TURF TO EXPERTS? Dia Gainor, NASEMSO Executive Director dia@nasemso.org 208-861-4841

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