Use of the injury severity score (ISS) in a pediatric population

Wesson, D. E.; Williams, J. I.; Spence, L.J.; Filler, R. M.; Armstrong, P. F.

Affiliations

¹Department of Surgery, the University of Toronto, the Hospital for Sick Children, Toronto

²Department of Epidemiology and Biostatistics, McGill University

Abstract

WE are conducting a prospective study to test the validity of the Injury Severity Score (ISS) in a group of 250 children with major trauma (one severe injury AIS ≥ 4 or two or more moderate injuries - AIS ≥ 2). The ISS was compared to mortality and functional status by the Rand Health Insurance Study (HIS) measures at discharge and 6 months post injury. The predictive validity of the ISS was found to be good. The mean ISS was 40 in the non-survivors and 22 in the survivors (p < 0.001). Apart from deaths due to isolated head injuries, there was only one death in a child with ISS < 30. We have completed 6 month follow up interviews on 81 patients. There was an unexpectedly high incidence of physical functional limitations. Forty-two (52%) had a persistent functional limitation, 39 (48%) did not. The ISS seems to be a reliable and valid measure of injury severity in children.

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