ISS - RTS - TRISS

(Injury Severity Score - Revised Trauma Score - Trauma Injury Severity Score)

Variables

Severity level (help)

Points

Head and neck

Face

Chest

Abdomen, pelvic contents

Extremity, pelvic girdle

External

ISS =
.

Respiratory rate (per min)

Systolic blood pressure (mmHg)

Glasgow coma scale (help)

RTS =
.

Age
(Pediatric cases (Ages < 15) use the blunt model for both blunt and penetrating mechanisms of injury.)

Predicted death rate (blunt)
TRISS =

Predicted death rate (penetrating)
TRISS =

ISS = Sum ((three most weighted region injury)²).
ISS equals 75 for any patient with an AIS 6 injury.

TRISS (blunt): Logit =-0.4499 + RTS*0.8085 + ISS*-0.0835 + (age.points)*-1.7430
Predicted death rate = 1/(1 + e^Logit)

TRISS (penetrating): Logit =-2.5355 + RTS*0.9934 + ISS*-0.0651 + (age.points)*-1.1360
Predicted death rate = 1/(1 + e^Logit)

RTS = Sum ((resp.rate.points)*0.2908; (sbp.points)*0.7326; (Glasgow.points)*0.9368)

References

Baker SP et al. The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 1974;14:187-96.
Champion HR et al. A Revision of the Trauma Score. J Trauma 1989;29:623-9.
Boyd CR et al. Evaluating Trauma Care : The TRISS Method. J Trauma 1987;27:370-8.
Champion HR et al. Coefficients update. J Trauma 1995 Editorial Comment. 38:94-5.

Web page by : Jean-Yves Marandon Centre Chirurgical Marie Lannelongue (France)

With help from Larry Bain, B.S.(Trianalytics.com),
Jean-Marc Rosengard (jmrosengard.com)
and Karim Brohi, BSc FRCS FRCA (Director, trauma.org)

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Definitions

The current definition of ISS as used in the TRISS model incorporates AIS 6 severity - described in the AIS Manual (AIS-90)

Recommendations For Uniform Reporting of Data following Major Trauma - The Utstein Style (An Initiative)
International Trauma Anaesthesia and Critical Care Society (ITACCS) Initiative
http://pdm.medicine.wisc.edu/itaccs.htm

Blunt injury : Non-penetrating, but including crush, laceration, amputation and asphyxia.
Penetrating injury : Bullet, knife, or spike.

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Eyes Open

Verbal

Motor

Spontaneous
To speech
To pain
Absent

Converses / Oriented
Converses / Disoriented
Inappropriate
Incomprehensible
Absent

Obeys
Localizes pain
Withdraws (flexion)
Decorticate (flexion) rigidity
Decerebrate (extension) rigidity
Absent

Glasgow=

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Variables	Severity level (help)	Points
Head and neck
Face
Chest
Abdomen, pelvic contents
Extremity, pelvic girdle
External
ISS = .
Respiratory rate (per min)
Systolic blood pressure (mmHg)
Glasgow coma scale (help)
RTS = .
Age (Pediatric cases (Ages < 15) use the blunt model for both blunt and penetrating mechanisms of injury.)
Predicted death rate (blunt) TRISS =		Predicted death rate (penetrating) TRISS =
ISS = Sum ((three most weighted region injury)²). ISS equals 75 for any patient with an AIS 6 injury.	TRISS (blunt): Logit =-0.4499 + RTS0.8085 + ISS-0.0835 + (age.points)*-1.7430 Predicted death rate = 1/(1 + e^Logit)	TRISS (penetrating): Logit =-2.5355 + RTS0.9934 + ISS-0.0651 + (age.points)*-1.1360 Predicted death rate = 1/(1 + e^Logit)
RTS = Sum ((resp.rate.points)0.2908; (sbp.points)0.7326; (Glasgow.points)*0.9368)

Eyes Open	Verbal	Motor
Spontaneous To speech To pain Absent	Converses / Oriented Converses / Disoriented Inappropriate Incomprehensible Absent	Obeys Localizes pain Withdraws (flexion) Decorticate (flexion) rigidity Decerebrate (extension) rigidity Absent