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Ressources et utilitaires

Scoring systems for ICU and surgical patients:

ISS - RTS - TRISS (Injury Severity Score - Revised Trauma Score - Trauma Injury Severity Score)

Variables	Severity level (help)	Points
Head and neck	Minor (1) Moderate (2) Serious (3) Severe (4) Critical (5) Maximum (6)
Face	Minor (1) Moderate (2) Serious (3) Severe (4) Critical (5) Maximum (6)
Chest	Minor (1) Moderate (2) Serious (3) Severe (4) Critical (5) Maximum (6)
Abdomen, pelvic contents	Minor (1) Moderate (2) Serious (3) Severe (4) Critical (5) Maximum (6)
Extremity, pelvic girdle	Minor (1) Moderate (2) Serious (3) Severe (4) Critical (5) Maximum (6)
External	Minor (1) Moderate (2) Serious (3) Severe (4) Critical (5) Maximum (6)
ISS =
Respiratory rate (per min)	0 1 - 5 6 - 9 10 - 29 > = 30
Systolic blood pressure (mmHg)	0 1 - 49 50 - 75 76 - 89 > = 90
Glasgow coma scale (help)	3 4 - 5 6 - 8 9 - 12 13 - 15
RTS =
Age (Pediatric cases (Ages < 15) use the blunt model for both blunt and penetrating mechanisms of injury.)	Age < 15 years 15 <= Age <55 Age >= 55 years
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 + eLogit)	TRISS (penetrating): Logit =-2.5355 + RTS*0.9934 + ISS*-0.0651 + (age.points)*-1.1360 Predicted death rate = 1/(1 + eLogit)
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.

 

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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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