To determine trauma patients who might benefit from intensive care, 1562 patients following a motor-vehicle crash admitted to 8 hospitals over 24 months were evaluated. Based on injury severity score (ISS), patients were stratified into 5 categories:​ 1-8, 9-15, 16-24, 25-40, and > 40. 1055 (67.5%) patients had ISS < 16 with 5 deaths (0.5% mortality). Of those 293 (27.8%) were treated in the ICU and comprised 45% of patients treated in the ICU. In this ISS < 16 subcategory comparison between patients treated in ICU and those non-treated in ICU showed no significant difference in mortality, revised trauma score, age, glasgow coma score or presence of preexisting morbidity. Patients treated in ICU had ICU stay of 3 + 4 days, had significantly more nosocomial infections and longer hospital stay (14.7 vs 10.2 days, p < 0.005). ISS ≥ 16 can be used as a threshold for triaging patients for admission to ICU or for early discharge from ICU. Its use can result in more efficient utilization of ICU without seriously reducing the quality of care.