Dia Gainor, NASEMSO

National EMS System Information System (NEMSIS) Version 3.0 Compliant Out-of-Hospital Records

Emergency Department Discharge Databases

Hospital Discharge Databases Trauma Registries

Physiological scoring systems Glasgow coma scale Trauma score Revised trauma score TRISS methodology

Anatomical scoring systems Abbreviated injury score Injury severity scoreICD-9 Injury Severity Score

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

1 = Minor 2 = Moderate 3 = Serious 4 = Severe 5 = Critical 6 = Maximum (Untreatable)

Head/neck Face Chest Abdomen Extremity External (skin)

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

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

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

Anatomical scoring system for patients with multiple injuries

ISS score correlates with mortality, morbidity & hospital stay

Bivariate correlation of mortality % with ISS and age

Dia Gainor, NASEMSO Executive Directordia@nasemso.org208-861-4841