Scoring multitrauma patients: which scoring system?

Abstract

Two methods of estimating the severity of injury and evaluating outcome, the Injury Severity Score (ISS) and the Polytrauma-Schlussel (PTS), were evaluated. The records of 37 victims of multiple injuries were assessed retrospectively by nine trauma surgeons using both methods of scoring. The agreement among the users was calculated by standard deviation. The standard deviation (SD) among users was smaller for the PTS (4.1) than for the ISS (6.2). Each method of scoring comprises six components contributing to the total score. The three highest scoring components of the ISS were first squared and then summated, the sum being the total ISS score. All the PTS categories were summated. Comparison of the SD for each of the components was not possible. However, the category or categories which mostly influenced the standard deviation could be indicated. For the ISS these were the circulation and central nervous sytem and for PTS, the limbs. We prefer the Polytrauma-Schlussel method because this takes account of age, needs revision of only one category and gives more consistent results among users.