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Home > Articles > Injury Severity Score

Introduction

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 Abbreviated Injury Scale (AIS) score, 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.

An example of the ISS calculation is shown below:

Region Injury Description AISSquare Top Three
Head & NeckCerebral Contusion39
FaceNo Injury0 
ChestFlail Chest416
AbdomenMinor Contusion of Liver
Complex Rupture Spleen
2
5
25
ExtremityFractured femur3 
ExternalNo Injury0 
 Injury Severity Score: 50

The ISS takes values from 0 to 75. If an injury is assigned an AIS of 6 (maximal), the ISS score is automatically assigned to 75. The ISS correlates linearly with mortality, morbidity, hospital stay and other measures of severity.

It's 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 Calculator

INJURY SEVERITY SCORE
 
Abbreviated Injury Scale:
Head
Face
Chest
Abdomen
Extremity
External
ISS:


The ISS Calculator will open as a standalone window on your desktop.

References

Baker SP et al, "The Injury Severity Score: a method for describing patients with multiple injuries and evaluating emergency care", J Trauma 14:187-196;1974

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