Vascular Scoring Systems

Abstract

An appreciation of various trauma scoring systems and an understanding of their specific application to gauging vascular injuries can help predict morbidity and mortality. A patient’s injuries can thereby be better prioritized when working with a multidisciplinary team of trauma, orthopedic, and vascular surgeons. The basis for most scoring systems is the Abbreviated Injury Score (AIS), which ranks injuries from 1 (minor) to 6 (unsurvivable). An anatomically derived scoring system, the Injury Severity Score (ISS), uses the AIS and assigns scores to one of six body regions. The limitation of both scoring systems is that they do not properly take into account orthopedic and vascular injuries. Despite efforts from multiple centers, there is not yet a concise scoring system that incorporates the full range of general trauma, orthopedic, and vascular injuries to predict outcomes. Using a combination of AIS, ISS, the Revised Trauma Score, Glasgow Coma Scale, and clinical judgment in the context of working as a multidisciplinary team may be the best management strategy when caring for the polytrauma patient.