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Injury Severity Score - Determining The Seriousness Of Injuries

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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 three most severely injured body regions have their score squared and added together to produce the ISS score.

COPYRIGHT_SPINE: Published on https://spinal-injury.net/injury-severity-score/ by Dr. Bill Butcher on 2022-10-24T11:17:32.075Z

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ISS Calculator

The ISS Calculator can be found online. One just simply needs to input the right details and the computation will be performed online on someone’s behalf.

The parts of the body under the “Abbreviated Injury Scale” include the Head, Face, Chest, Abdomen, Extremities, and External.

In her article published by MDCalc.com, Dr. Susan Baker, an epidemiologist at Johns Hopkins Bloomberg School of Public Health who specializes in injury prevention, identified seven descriptions for a specific injury.

For example, the question is: “Head and neck worst injury?” The following are the answers (as mentioned by Dr. Baker) to arrive at an Injury Severity Score:

  • No injury
  • Minor
  • Moderate
  • Serious
  • Severe
  • Critical
  • Unsurvivable
A female adult with a head bandage gets her temperature checked via an automatic thermometer
A female adult with a head bandage gets her temperature checked via an automatic thermometer

ISS Calculation

A sample calculation for an Injury Severity Score is shown below:

1. First example

a. Region - head and neck

b. Injury Description - cerebral contusion

c. Abbreviated Injury Scale (AIS) - 3

d. Square Top Three - 9

2. Second example

a. Region - face

b. Injury Description - no injury

c. AIS - 0

d. Square Top Three - none

3. Third example

a. Region - chest

b. Injury Description - flail chest

c. AIS - 4

d. Square Top Three - 16

Illustration of a rib cage with four adhesive bandages on the right side to show a flail chest
Illustration of a rib cage with four adhesive bandages on the right side to show a flail chest

4. Fourth example

a. Region - abdomen

b. First Injury Description - minor contusion of liver

c. AIS - 2

d. Second Injury Description - complex rupture spleen

e. AIS - 5

f. Square Top Three - 25

A spiral bandage is placed on the abdomen of a slim male wearing a blue long sleeved polo
A spiral bandage is placed on the abdomen of a slim male wearing a blue long sleeved polo

5. Fifth example

a. Region - extremity

b. Injury Description - fractured femur

c. AIS - 3

d. Square Top Three - none

6. Sixth example

a. Region - external

b. Injury Description - no injury

c. AIS - 0

d. Square Top Three - (blank)

Add all the scores under “Square Top Three” and the Injury Severity Score is 50.

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About The Authors

Dr. Bill Butcher

Dr. Bill Butcher - With more than two decades of experience, Dr. Bill Butcher aims to provide a repository for educational materials, sources of information, details of forthcoming events, and original articles related to the medical field and about health subjects that matter to you. His goal is to help make your life better, to help you find your way when faced with healthcare decisions, and to help you feel better about your health and that of your family.Bill received his medical degree at Boston University School of Medicine and spent his entire career helping people find the health and medical information, support, and services they need. His mission is to help millions of people feel fantastic by restoring them to optimal health.

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