Trauma scoring systems are used for triaging trauma patients, predicting outcomes, quality assurance, and research. Physiologic scoring systems measure vital signs and organ function while anatomic systems score injury severity based on location. Combined systems incorporate both anatomic and physiologic factors. The Glasgow Coma Scale measures brain injury severity. The Revised Trauma Score and Injury Severity Scale are commonly used to assess trauma patients. The Abbreviated Injury Scale grades injury severity from 1-6 while the Injury Severity Scale combines AIS scores from the three most severe regions to give an overall score predicting mortality risk. The Mangled Extremity Severity Score predicts amputation need based on limb injury, ischemia, shock,

1. Trauma Scoring Systems
Pembimbing
dr. Onarisa Ayu, M.Ked (Surg), Sp.OT (K)
PPDS Prodi Bedah Plastik Rekonstruksi & Estetik
Setia Yuda Nugraha
Feri Zulfahmi

2. Purpose of scoring systems
• appropriate triage and classification of trauma patients
• predict outcomes for patient and family counseling
• quality assurance
• research (extremely useful for the study of outcomes)

3. Classifications

4. Physiologic
• Revised Trauma Score (RTS)
• Acute Physiology and Chronic Health Evaluation (APACHE)
• Sequential Organ Failure Assessment Score (SOFA)
• Systemic Inflammatory Response Syndrome Score (SIRS)
• Emergency Trauma Score

5. Anatomic
• Abbreviated Injury Score (AIS)
• Injury Severity Score (ISS)
• New Injury Severity Score (NISS)
• Anatomic Profile (AP)
• Penetrating Abdominal Trauma Index (PATI)
• ICD-based Injury Severity Score (ICISS)
• Trauma Mortality Prediction Model (TMPM-ICD9)

6. Combined
• Trauma Score - Injury Severity Score (TRISS)
• A Severity Characterization of Trauma (ASCOT)
• International Classification of Diseases Injury Severity Score (ICISS)
• Ganga Hospital Open Injury Score (GHOIS)

7. • quantifies severity of head injury by measuring CNS function
• initial assessment tool
• continual re-evaluation of head injured patients

8. GCS (Glasgow Coma Scale)

9. Interpretation
brain injury
• severe <9
• moderate 9-12
• minor 13 and above

10. Revised Trauma Score (RTS)
• most widely used prehospital field triage tool

11. Injury Severity Scale (ISS)
• first scoring system to be based on anatomic criteria
• defines injury severity for comparative purposes
• based on scores of 9 anatomic regions head
• face, neck, thorax, abdominal and pelvic contents, spine, upper
extremity, lower extremity, external

12. Abbreviated Injury Scale (AIS) grades
• 0 - no injury
• 1 - minor
• 2 - moderate
• 3 - severe (not life-threatening)
• 4 - severe (life-threatening, survival probable)
• 5 - severe (critical, survival uncertain)
• 6 - maximal, possibly fatal

13. Injury Severity Scale (ISS)
• ISS = sum of squares for the highest AIS grades in the three most
severely injured ISS body regions
• ISS = A2 + B2 + C2
• where A, B, C are the AIS scores of the three most severely injured ISS
body regions
• scores range from 1 to 75
• single score of 6 on any AIS region results in automatic score of 75
• ISS > 15 associated with mortality of 10%

14. Mangled Extremity Severity Score (MESS)
-used to predict necessity of amputation after lower extremity trauma
• skeletal and soft tissue injury (graded 1-4)
• limb ischemia (graded 1-3)
• shock (graded 0-2)
• age (graded 0-2)
- score of >7 is predictive of amputation
- score determined by adding scores of components in four categories