Injury severity scoring: influence of trauma surgeon involvement on accuracy

Since its introduction in 1974, the Injury Severity Score (ISS) has been considered the "gold standard" for anatomic injury severity assessment. In many trauma centers, the trauma program manager and/or trauma registrar perform this task with minimal or sporadic input from trauma surgeons. This prospective study describes the effect of consistent, timely trauma surgeon involvement in the accuracy of ISS scoring. Prospective data collection on 3,261 consecutive trauma patients admitted to a Level I Trauma center occurred over a 2-year period. A comparison was made between the ISS score calculated by the trauma program manager and registrar versus after collaboration with trauma surgeons. This collaboration occurred weekly for 60 minutes. Surgeon involvement in ISS scoring does affect injury scoring accuracy 5.2% of the time and results in an increased ISS that is greater than or equal to sixteen in 1.2% of instances. Trauma surgeon involvement in ISS scoring is a valuable return for the time invested.