This paper is only available as a PDF. To read, Please Download here.
Abstract
A retrospective review of 1900 road accident victims attending the emergency departments
of two Melbourne hospitals was undertaken to identify Injury Severity Score levels
which could distinguish between minor, moderate, severe and critical injury. Injuries
scoring ISS 6 or below were designated ‘minor’ because they were associated with a
low risk of requiring admission to hospital. Case notes of patients scoring above
ISS 6 were then reviewed by a panel of clinicians, who independently rated each patient's
overall injury severity as moderate, severe or critical according to what was recorded
in the notes and their ‘clinical’ judgement. ISS values were compared with clinicians'
ratings. Measures of each clinician's individual rating consistency, and correlation
between pairs of clinicians with respect to inter-rater consistency, were made. By
combining data from both hospitals it emerged that ‘moderate’ injury corresponded
to ISS 8–13, ‘severe’ to ISS 14–20 and ‘critical’ to ISS 21 and above. These ISS breakpoints
will be useful in selecting groups of injured patients for future trauma audit studies.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to InjuryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Grading of Metropolitan Hospitals.Staff Notice 82/5, June 1982. 1982;
- The ISS: A method for describing patients with multiple injuries and evaluating emergency care.J. Trauma. 1974; 14: 187
- Major trauma in an urban New Zealand setting: resource requirements.Aust N. Z. J. Surg. 1987; 57: 543
- Clinical prospective injury scoring: When is it accurate?.J. Trauma. 1989; 29: 613
- The Abbreviated Injury Scale.Association for the Advancement of Automotive Medicine, Des Plaines, IL 60018, USA1990 (1990 Revision)
- The management of injuries — a review of deaths in hospital.Aust N. Z. J. Surg. 1988; 58: 463
- Interhospital transfer in the management of acute trauma.Aust N. Z. J. Surg. 1990; 60: 441
- The resuscitation of the injured in the accident and emergency department — a medical audit.Injury. 1985; 16: 249
- Use of ranks in one-criterion variance analysis.J. Amer. Statist. Assoc. 1952; 4: 583
- Rating AIS severity using emergency department sheet vs. inpatient charts.J. Trauma. 1985; 25: 984
- Injury severity scoring: a comparison of early clinical versus discharge diagnosis.Accid. Anal. Prev. 1989; 21: 386
- The use of injury severity scales in the early management of road trauma.in: M.S. Thesis. University of Melbourne, Australia1988
Article info
Publication history
Accepted:
February 26,
1992
Identification
Copyright
© 1992 Published by Elsevier Inc.
