Scoring systems in trauma

  • A. J. Sutcliffe
Conference paper


Howard Champion [1] has recently written that ‘severity scales to characterize the nature and extent of injury are important adjuncts to trauma care systems, trauma research and many of the elements of a complete public health approach to injury’. Nobody would dispute this statement. Unfortunately however, 30 years of effort have not yet produced a trauma score that is universally accepted. This is probably because a score that satisfies all needs with adequate sensitivity and specificity is an unachievable goal. Previous contributors to this series of texts have described the characteristics and shortcomings of many of the scores that have been proposed [2, 3]. This chapter gives an overview of the properties of scoring systems and discusses why the search for a universally acceptable trauma score is unlikely to be successful.


Injury Severity Score Trauma Center Revise Trauma Score Abbreviate Injury Score Systemic Inflammatory Response Syndrome Score 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Champion HR (2002) Trauma scoring. Scand J Surg 91:12–22PubMedGoogle Scholar
  2. 2.
    Sutcliffe AJ (2000) Update on trauma scoring. In Gullo A (ed) Anaesthesia, pain, intensive care and emergency medicine 14. Springer-Verlag, Milan, pp 411–416Google Scholar
  3. 3.
    Della Corte F, Vignazia GL, Cavaglia M (2002) Trauma scoring systems. In: Gullo A (ed) Anaesthesia, pain, intensive care and emergency medicine 16. Springer-Verlag, Milan, pp 351–361CrossRefGoogle Scholar
  4. 4.
    Sacco WJ, MacKenzie EJ, Champion HR, et al (1999) Comparison of alternative methods for assessing injury severity based on anatomic descriptors. J Trauma 47:441–446PubMedCrossRefGoogle Scholar
  5. 5.
    Vassar MJ, Lewis FR, Chambers JA, et al (1999) Prediction of outcome in intensive care trauma patients: a multicenter study of Acute Physiology and Chronic Health Evaluation (APACHE), Trauma and Injury Severity Score (TRISS), and a 24-hour intensive care unit (ICU) point system. J Trauma 47:324–329PubMedCrossRefGoogle Scholar
  6. 6.
    Gebhard F, Pfetsch H, Steinbach G, et al (2000) Is interleukin 6 an early marker of injury severity following major trauma in humans? Arch Surg 135:291–295PubMedCrossRefGoogle Scholar
  7. 7.
    Napolitano LM, Ferrer T, McCarter RJ, Scalea TM (2000) Systemic inflammatory response syndrome score at admission independently predicts mortahty and length of stay in trauma patients. J Trauma 49:647–652PubMedCrossRefGoogle Scholar
  8. 8.
    Bochicchio GV, Napohtano LM, Joshi M, et al (2001) Systemic inflammatory response syndrome score at admission independently predicts infection in blunt trauma patients. J Trauma 50: 817–820PubMedCrossRefGoogle Scholar
  9. 9.
    Malone DL, Kuhis D, Napolitano LM, et al (2001) Back to basics: validation of the admission systemic inflammatory response syndrome score in predicting outcome in trauma. J Trauma 51: 458–463PubMedCrossRefGoogle Scholar
  10. 10.
    Woertgen C, Rothoeri RD, Metz C, Brawanski A (1999) Comparison of clinical, radiologic, and semm marker as prognostic factors after severe head injury. J Trauma 47:1126–1130PubMedCrossRefGoogle Scholar
  11. 11.
    Templeton J, Oakley PA, MacKenzie G, et al (2000) A comparison of patient characteristics and survival in two trauma centers located in different countries. Injury 31:493–501PubMedCrossRefGoogle Scholar
  12. 12.
    International Trauma Anesthesia and Critical Care Society (1999) Recommendations for uniform reporting of data following major trauma- the Utstein Style: an initiative. Prehospital Disaster Med 14:118–145Google Scholar
  13. 13.
    Airey CM, Cheli SM, Rigby AS et al (2001) The epidemiology of disabihty and occupation handicap resulting from major traumatic injury. Disabil Rehabil 23:509–515PubMedCrossRefGoogle Scholar
  14. 14.
    Michaels AJ, Madey SM, Krieg JC, Long WB (2001) Traditional injury scoring underestimates the relative consequences of orthopedic injury. J Trauma 50:389–395PubMedCrossRefGoogle Scholar
  15. 15.
    Bosse MJ, MacKenzie EJ, Kellam JF, et al (2001) A prospective evaluation of the clinical utility of the lower-extremity injury-severity scores. J Bone Joint Surg Am 83-A:3–14PubMedGoogle Scholar
  16. 16.
    Nissen JJ, Jones PA, Signorini DF, et al (1999) Glasgow head injury outcome prediction programme: an independent assessment. J Neurol Neurosurg Psychiatry 67:796–799PubMedCrossRefGoogle Scholar
  17. 17.
    Wohltman CD, Franklin GA, Boaz PW, et al (2001) A multicenter evaluation of whether gender dimorphism affects survival after trauma. Am J Surg 181:297–300CrossRefGoogle Scholar
  18. 18.
    Pickering S A, Esberger D, Moran CG (1999) The outcome following major trauma in the elderly. Predictors of survival. Injury 30:703–706PubMedCrossRefGoogle Scholar
  19. 19.
    Lorrelli DR, Kralovich KA, Seguin C (2001) The impact of pre-existing end-stage renal disease on survival in acutely injured trauma patients. Am Surg 67:693–696Google Scholar
  20. 20.
    Chesnut RM, Marshall LF, Klauber MR, et al (1993) The role of secondary brain injury in determining outcome from severe head injury. J Trauma 34:216–224PubMedCrossRefGoogle Scholar
  21. 21.
    Margulies DR, Cryer HG, Mc Arthur DL, et al (2001) Patient volume per surgeon does not predict survival in adult level 1 trauma centers. J Trauma 50:597–601PubMedCrossRefGoogle Scholar
  22. 22.
    Pasquale MD, Peitzman AB, Bednarski J, Wasser TE (2001) Outcome analysis of Pennsylvania trauma centers: factors predictive of nonsurvival in seriously injured patients. J Trauma 50:465–472PubMedCrossRefGoogle Scholar
  23. 23.
    Clancy TV, Maxwell GJ, Covington DL, et al (2001) A statewide analysis of level 1 and 2 trauma centers for patients with major injuries. J Trauma 51:346–351PubMedCrossRefGoogle Scholar

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© Springer-Verlag Italia 2003

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  • A. J. Sutcliffe

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