Measurement of the Magnitude of Injury: A Review of the Trauma Scoring Systems

Background: Trauma scoring systems are a vast, ever expanding and often confusing field. There is a need for trauma surgeons, residents and all who manage trauma to be conversant with the more frequently used systems in order to be able to appreciate changes in trauma care emanating from trauma research. Objective: To review the current trauma scoring systems with a view to highlighting their various bases, strengths, weaknesses and areas of applicability. Methods: Literature review of the current trauma scoring systems was done using textbooks, journals and internet searches mainly with pubmed and Medline. Results: There are a plethora of trauma scoring systems. All have their various strengths and weaknesses. Different systems perform differently in different situations depending on which outcome parameter is of interest. The more frequently used systems such as the AIS, ISS and TRISS are discussed in detail. Conclusion: Although trauma scores are not designed for clinical decision making in individual patients, a good understanding of the basis of the more commonly used systems will enable doctors involved in the care of trauma patients to appreciate changes in patient care algorithms emanating from trauma research.