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J R Soc Med. 1980 January; 73(1): 19–22.
PMCID: PMC1440048

Measuring the severity of injury1


Attempts have been made to improve the Injury Severity Score (ISS) system of Baker et al. (1974) using plasma lactate data obtained from 277 patients shortly after injury and before treatment. The ISS is based on the Abbreviated Injury Scale (AIS) values of the individual injuries, being the sum of the squares of the values for the three most severely injured regions. Log (plasma lactate concentration) is positively related to ISS over its whole range. It was not possible to vary the AIS values, either on clinical grounds or using a computer, in such a way that the variance of the log (plasma lactate concentration) about its regression line with ISS was significantly reduced. With a score based on the sum of the squares of the AIS values for all the patient's injuries, some improvement to the AIS values could be made but it was not statistically significant. At the present time Baker's ISS method would seem to be the best way of grading injuries for acute studies.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Baker SP, O'Neill B, Haddon W, Jr, Long WB. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma. 1974 Mar;14(3):187–196. [PubMed]
  • Bull JP. Measures of severity of injury. Injury. 1978 Feb;9(3):184–187. [PubMed]
  • Betts TA, Espir M, Gibberd FB, Grant RHE, Jeavons PM, Richens A, Whitty CWM. Epilepsy and Driving. Br Med J. 1974 May 11;2(5914):c332–332. [PMC free article]
  • Peretz DI, Scott HM, Duff J, Dossetor JB, MacLean LD, McGregor M. The significance of lacticacidemia in the shock syndrome. Ann N Y Acad Sci. 1965 Jul 31;119(3):1133–1141. [PubMed]
  • Stoner HB, Barton RN, Little RA, Yates DW. Measuring the severity of injury. Br Med J. 1977 Nov 12;2(6097):1247–1249. [PMC free article] [PubMed]
  • Stoner HB, Frayn KN, Barton RN, Threlfall CJ, Little RA. The relationships between plasma substrates and hormones and the severity of injury in 277 recently injured patients. Clin Sci (Lond) 1979 Jan;56(6):563–573. [PubMed]
  • Vitek V, Cowley RA. Blood lactate in the prognosis of various forms of shock. Ann Surg. 1971 Feb;173(2):308–313. [PubMed]
  • Yates DW. Airway patency in fatal accidents. Br Med J. 1977 Nov 12;2(6097):1249–1251. [PMC free article] [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press