Comparison of the Injury Severity Score with the New Injury Severity Score in Trauma Patients with Chest injury

ABSTRACT

PURPOSE: The Injury Severity Score (ISS), which is defined as the sum of the squares of the single highest Abbreviated Injury Scale (AIS) score in each of the three most severely injured body regions, does not take into account multiple injuries in the same body region. The New ISS (NISS), which is defined as the sum of the squares of the AIS scores of a patient's three most severe injuries regardless of body region, has been proposed to provide a more accurate measure of trauma severity. The purpose of this study was to evaluate the ISS and the NISS in patients with chest trauma. METHODS: A retrospective study of 263 cases of trauma victims with chest injuries, who visited the emergency center of Daegu Catholic University Hospital during a 42-month-period from January 1998 to June 2001, was performed. For each patient, we calculated the ISS and the NISS. The power of the two scoring systems to predict hospital length of stay, intensive care, operation, and mortality was gauged through comparison of receiver operating characteristic (ROC) curves. RESULTS: The mean ISS was 12, and the mean NISS was 14. The areas under the curves (AUC) of the hospital length of stay (0.764 vs 0.762), operation (0.772 vs 0.764), and mortality (0.873 vs 0.860) were greater for the ISS than the NISS. CONCLUSION: The significant difference in the predictive abilities of the ISS and the NISS reported in studies of severe blunt trauma patients was not seen in this review of moderate trauma patients with chest injuries.