Injury Severity Score (ISS)

Anwendung

Gesamtscore für mehrfach verletzte Patienten
Anmerkung
Jede Verletzung wird einer der 6 unten aufgeführten Regionen zugeordnet. Den einzelnen Verletzungen wird eine Zahl (Abbreviated Injury Scale - AIS) auf einer Scala von 1-6 zugeordnet. Der ISS wird berechnet, indem jeweils die höchste Zahl der 3 am schwersten verletzten Körperregionen quadriert wird und diese dann summiert werden. Die maximale Punktzahl beträgt 75. Wird einer Körperregion eine 6 zugeordnet (nicht überlebbare Verletzung) ist der ISS automatisch 75.

Region Beschreibung der Verletzung und AIS [1][2]
  
General

aches all over

1

minor laceration, contusion and abrasions (simple closure)

1

1st degree burns

1

small 2nd or 3rd degree burns

1

extensive contusion or abrasion

2

large laceration

2

avulsion less than 3 inches wide

2

2nd or 3rd degree burn involving 10-20% BSA

2

large lacerations involving more than 2 extremities

3

large avulsions, >= 3 inches wide

3

2nd or 3rd degree burn involving 20-30% of BSA

3

severe lacerations and/or avulsion with dangerous hemorrhage

4

2nd or 3rd degree burns involving 30-50% of BSA

4

2nd or 3rd degree burns involving > 50% of BSA

5

  
Face
 
  
Head & Neck

cerebral injury with headache or dizziness but no loss of consciousness

1

whiplash complaint with no anatomical or radiological evidence

1

abrasions and contusions of ocular apparatus (lids, conjunctivae, cornea, uveal injuries)

1

vitreous or retinal hemorrhages

1

fractures and/or dislocation of teeth

1

cerebral injury with/without skull fracture, less than 15 minutes unconsciousness, no post-traumatic amnesia

2

undisplaced skull or facial bone fractures or compound fracture of nose

2

laceration of the eye and appendages

2

retinal detachment

2

disfiguring lacerations

2

whiplash severe complaints with anatomical and radiologic evidence

2

cerebral injury with or without skull fracture, with unconsciousness more than 15 minutes, without severe neurological signs, brief post-traumatic amnesia (less than 3 hours)

3

displaced closed skull fracture without unconsciousness or other signs of intracranial injury

3

loss of eye

3

avulsion of optic nerve

3

displaced facial bone fractures or those with antral or orbital involvement

3

cervical spine fractures without cord damage

3

cerebral injury with or without skull fracture with unconsciousness of more than 15 minutes, with definite abnormal neurological signs; post-traumatic amnesia 3-12 hours

4

compound skull fracture

4

cerebral injury with or without skull fracture with unconsciousness of more than 24 hours; post-traumatic amnesia more than 12 hours

5

intracranial hemorrhage

5

signs of increased intra-cranial pressure (decreasing state of consciousness, bradycardia under 60, progressive rise in blood pressure, or progressive pupil inequality)

5

cervical spine injury with quadraplegia

5

major airway obstruction

5

  
Chest

muscle ache or chest wall stiffness

1

simple rib or sternal fracture

2

major contusion of chest wall without hemothorax or pneumothorax or respiratory embarrassment

2

multiple rib fractures without respiratory embarrassment

3

hemothorax

3

pneumothorax

3

rupture of diaphragm

3

lung contusion

3

open chest wounds

4

flail chest

4

pneumomediastinum

4

myocardial contusion without circulatory embarrassment

4

pericardial injuries

4

chest injuries with major respiratory embarrassment (laceration of trachea, hemomediastinum, etc.)

5

aortic laceration

5

myocardial rupture or contusion, with circulatory embarrassment

5

  
Abdomen

muscle ache

1

seat belt abrasion

1

major contusion of abdominal wall

2

contusion of abdominal organs

3

extraperitoneal bladder rupture

3

retroperitoneal hemorrhage

3

avulsion of ureter

3

laceration of urethra

3

thoracic or lumbar spine fracture without neurological involvement

3

minor laceration of intra-abdominal contents (to include ruptured spleen, kidney and injuries to tail of pancreas)

4

intraperitoneal bladder rupture

4

avulsion of genitals

4

thoracic and/or lumbar spine fracture with paraplegia

4

rupture, avulsion or severe laceration of intra-abdominal vessels or organs, except kidney, spleen or ureter

5

  
Extremity and Pelvis

minor sprains and fractures

1

dislocation of digits

1

compound fracture of digits

2

undisplaced long bone or pelvic fractures

2

major sprains of major joints

2

displaced simple long bone fractures

3

multiple hand and foot fractures

3

pelvic fracture with displacement

3

dislocation of major joints

3

multiple amputations of digits

3

laceration of the major nerves or vessels of extremities

3

multiple closed long-bone fractures

4

amputation of limbs

4

multiple open limb fractures

5

  
  
 Die Zahlen in jeder Körperregion bedeuten:
 Minor
 Moderate
 Serious
 Severe
 Critical
 Unsurvivable
  
 
[1] Copes WS, Sacco WJ, Champion HR, Bain LW, "Progress in Characterising Anatomic Injury", In Proceedings of the 33rd Annual Meeting of the Association for the Advancement of Automotive Medicine, Baltimore, MA, USA 205-218
[2] Es gibt viele Gemeinsamkeiten zwischen der AIS und der "organ injury scale" [3]
[3] 1. Moore EE, Shackford SR, Pachter HL, et al: Organ injury scaling - spleen, liver and kidney. J Trauma 29:1664, 1989
Moore EE, Cogbill TH, Malangoni MA, et al: Organ injury scaling II: pancreas, duodenum, small bowel, colon and rectum. J Trauma 30:1427, 1990
Moore EE, Cognill TH, Jurkovich GJ, et al: Organ injury scaling III: chest wall, abdominal vascular, ureter, bladder and urethra. J trauma 33:337,1992
Moore EE, Malangoni MA, Cogbill TH, et al: Organ injury scaling IV: thoracic vascular, lung, cardiac and diaphragm. J Trauma 36:229, 1994
Moore EE, Cogbill TH, Jurkovich MD, et al: Organ injury scaling: spleen and liver (1994 revision). J Trauma 38:323, 1995