USE OF THE INJURY SEVERITY SCORE IN HEAD-INJURY

As part of a study of the early management of severe head injury, the use Of the Glasgow Coma Score (GCS), Injury Severity Score (ISS) and T RISS was investigated. These injury scores were compared in correlatin g with outcome at one year as assessed by the Glasgow Outcome Score (G OS) and mortality. One hundred and thirty-one patients had a severe he ad injury, as defined by an ISS of 16 or higher, in whom the Abbreviat ed Injury Score (AIS) for craniocerebral injury was 3 or higher. Seven ty-eight of these also fulfilled the accepted GCS definition of severe head injury (GCS less than 8 with no eye-opening). Thirty-eight had e vacuation of an acute intracranial haematoma; 26 of these patients wou ld not have been classified as severe head injury by GCS. The overall mortality rate was 38 per cent, and 24 per cent for those transferred to the neurosurgical unit. TRISS was slightly better than GCS for pred icting outcome based on both GOS and mortality, however this differenc e was not significant. TRISS identified patients who died that are not considered as severe head injury by GCS. Use of TRISS allows the effe cts of systemic factors and other injuries to be taken into account wh en assessing severity of head injury.