Calculating Injury Severity Score | Medical Algorithm

Description

The Modified Injury Severity Score (MISS) differs slightly from the Injury Severity Score.

Differences:

(1) The "General" category of the Injury Severity Score is deleted.

(2) There is substitution of a Glasgow Coma Scale score for the neurologic component.

Similarities:

(1) The chest, abdomen, and extremities sections are the same.

(2) The scoring in each section is the same.

(3) The calculation of the final score is the same.

Head and Neck Components Retained

abrasions and contusions of ocular apparatus (lids, conjunctivae, cornea, uveal injuries)	head and neck	1
vitreous or retinal hemorrhages	head and neck	1
fractures and/or dislocation of teeth	head and neck	1
undisplaced skull or facial bone fractures or compound fracture of nose	head and neck	2
laceration of the eye and appendages	head and neck	2
retinal detachment	head and neck	2
disfiguring lacerations	head and neck	2
loss of eye	head and neck	3
avulsion of optic nerve	head and neck	3
displaced facial bone fractures or those with antral or orbital involvement	head and neck	3
"blow out" fractures of orbit	head and neck	3
bony or soft tissue injury with minor destruction	head and neck	4
major airway obstruction	head and neck	5

where:

• (1) "blow out" fractures and (2) bony or soft tissue injury with minor destruction are not included in the injury severity score tables (above)

Neurologic Component of Head and Neck Section Replaced by GCS

cerebral injury with headache or dizziness but no loss of consciousness	head and neck	1
whiplash complaint with no anatomical or radiological evidence	head and neck	1
cerebral injury with/without skull fracture, less than 15 minutes unconsciousness, no post-traumatic amnesia	head and neck	2
whiplash severe complaints with anatomical and radiologic evidence	head and neck	2
cerebral injury with or without skull fracture, with unconsciousness more than 15 minutes, without severe neurological signs, brief post-traumatic amnesia (less than 3 hours)	head and neck	3
displaced closed skull fracture without unconsciousness or other signs of intracranial injury	head and neck	3
cervical spine fractures without cord damage	head and neck	3
cerebral injury with or without skull fracture with unconsciousness of more than 15 minutes, with definite abnormal neurological signs; post-traumatic amnesia 3-12 hours	head and neck	4
compound skull fracture	head and neck	4
cerebral injury with or without skull fracture with unconsciousness of more than 24 hours; post-traumatic amnesia more than 12 hours	head and neck	5
intracranial hemorrhage	head and neck	5
signs of increased intra-cranial pressure (decreasing state of consciousness, bradycardia under 60, progressive rise in blood pressure, or progressive pupil inequality)	head and neck	5
cervical spine injury with quadraplegia	head and neck	5

Glasgow Coma Score Substitution

Glasgow coma score 15	neurologic	1
Glasgow coma score 13-14	neurologic	2
Glasgow coma score 9-12	neurologic	3
Glasgow coma score 5-8	neurologic	4
Glasgow coma score 3-4	neurologic	5

Calculation

The highest score, indicating the most severe injury, for each region is selected. These are then ranked from the highest to lowest value. The 3 highest values are then used to calculate the injury severity score.

injury severity score =

= ((highest region score) ^2) + ((second highest region score) ^2) + ((third highest region score) ^2)

Interpretation:

• minimum score: 0

• maximum score: 75

The mortality rate increases:

(1) with score

(2) with age

MISS Score	Mortality in 1980
0 to 10	0%
11 to 20	0%
21 to 30	29%
31 to 40	60%
> 40	100%

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Description

Specialty

Objective

ICD-10

Modified Injury Severity Score

Purpose: To assess a patient following a traffic accident using the Injury Severity Score.

Description

Specialty

Objective

ICD-10