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Fri Apr 15 23:47:20 BST 2011

I don't know of any studies that have ever used ISS>20 as a threshold
so I'm not sure where this specific value came from, but I do
understand the motivation.  As ISS>15 mortality has fallen over the
years, it is becoming increasingly difficult to use this group to
identify where improvements in process of care or novel therapeutics
can improve a mortality endpoint.  However this still represents a
large an important group of patients and we probably need to look at
non-mortality outcomes in this group to really evaluate how we deliver
care.  So I would not jettison the ISS>15 definition of severe trauma.
 (In fact the ISS 9-15 group are also important but often overlooked)

However there is logic in analysing a more severely injured cohort,
and the logical step up for ISS is 25 and above (ISS>24), which we
have defined as 'Critically Injured' in a previous paper
(http://www.ncbi.nlm.nih.gov/pubmed/20013932) as have others.  (25
being AIS 5 squared as a step up from 16 being AIS 4 squared).  These
are the group where you can more readily see a mortality impact of
improvements in care delivery etc.

Karim

On Wed, Apr 13, 2011 at 23:53, Zsolt J. Balogh
<Zsolt.Balogh at hnehealth.nsw.gov.au> wrote:
>
>
> Professor Zsolt J. Balogh, MD, PhD, FRACS
> Director of Trauma, John Hunter Hospital and Hunter New England Area Health Service
> Discipline Head of Traumatology, University of Newcastle
> Newcastle, NSW
> AUSTRALIA
> Tel: +61 2 49214259
> Fax: +61 2 49214274
> E-mail: zsolt.balogh at hnehealth.nsw.gov.au
>
>
>
>
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Charlene M Morris
> Sent: Thursday, 14 April 2011 8:55 AM
> To: Trauma-List [TRAUMA.ORG]
> Subject: Re: New definition of severe trauma?
>
> can link to the article be posted, please?
>
> cmm
>
> On Wed, Apr 13, 2011 at 6:41 PM, Zsolt J. Balogh <
> Zsolt.Balogh at hnehealth.nsw.gov.au> wrote:
>
>> Dear Cat,
>>
>> Please look at our article on the "definition of Polytrauma". Best Regards,
>> Zsolt Balogh
>>
>>
>>
>> Professor Zsolt J. Balogh, MD, PhD, FRACS
>> Director of Trauma, John Hunter Hospital and Hunter New England Area Health
>> Service
>> Discipline Head of Traumatology, University of Newcastle
>> Newcastle, NSW
>> AUSTRALIA
>> Tel: +61 2 49214259
>> Fax: +61 2 49214274
>> E-mail: zsolt.balogh at hnehealth.nsw.gov.au
>>
>>
>>
>>
>> -----Original Message-----
>> From: trauma-list-bounces at trauma.org [mailto:
>> trauma-list-bounces at trauma.org] On Behalf Of Heim Schoettker Katharina
>> Sent: Thursday, 14 April 2011 6:52 AM
>> To: trauma-list at trauma.org
>> Subject: New definition of severe trauma?
>>
>> Is anybody using ISS > 20 as definition of severe trauma? Health-care
>> politicians want Swiss-hospitals  to use ISS > 20 rather than > 15 for
>> definition of severe trauma. Is anybody aware of scientific arguments for
>> that?
>> Thanks
>> Cat
>> --
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>
>
>
> --
> THE best person for the job is the one who knows what to do at that given
> moment and is THERE, regardless of position, age or gender.
> --cmm
> --
> trauma-list : TRAUMA.ORG
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New definition of severe trauma?