[The classification of the severely and multiply injured--what has been established?]

Among the numerous scores available for the quantitative evaluation of injury severity, only few have proved themselves effective in clinical practice. The "Revised Trauma Score"--based on physiological variables--is the most widespread in preclinical use. The "Injury Severity Score"--based on anatomical data--is the most accepted for defined indices. However, a combination of the two, known as the "Trauma and Injury Severity Score (TRISS)", represents an international standard for quality control. Recent experience with TRISS in central Europe has shown that an increasing number of patients cannot be registered due to missing data. One reason for this is the intense preclinical treatment and its influence on physiological variables. The practicability of this method for quality control--combined with additional efforts--must be questioned in Germany. A score system based, for example, on the obligatory score of the "International Classification of Diseases", might be a good alternative with less effort required for each patient. Further investigations are necessary, however, before any final decisions are made.