Accident

Injury Severity
Accident Severity

Collision severity

Injury severity
 Early Severity Scales
Burden of injury – live or dead
Live - bleeding or not bleeding
Injured – treated or not treated
Treated – physician, doctor’s office
emergency room
released or admitted
 Injury Severity
Department of Transport
Fatal Injury - injuries which caused death in
less than 30 days after the accident.
Serious Injury - inpatient or fracture,
concussion, internal injuries, crushings,
severe cuts, severe shock type of injury or
death after 30 days.
Slight Injury - minor sprain, bruise, cut, or
requiring only roadside attention
WORKING DEFINITIONS OF
A FATALITY
Greece, Portugal, Spain use within 24
hours.
France uses within 6 days.
Italy uses within 7 days.
Most other states use within 30 days.

Correction Factors applied to get 30 day

equivalent, range from 1.3 (Spain) to
1.078 (Italy).
 Serious & Slight
Prone to error
severity assessed and
assigned by police at the
scene

Correct in ≈ 60% of cases

Therefore a better scale is
needed which could be
used by non medics and
the scale that is
anatomically based
 Abbreviated Injury Scale

Developed in the 1960’s by a group of 75

specialists from around the world.

Introduced in 1971

Revised in 1980, 1985, 1990,1998 & 2005

Abbreviated Injury Scale

Probability of threat to
life scale based on
individual injury
 7 digit code
used to classify an injury.
123456.7
The code describes
type of injury
location of injury
severity of injury
Abbreviated Injury Scale
123456.7

1 Body Region
2 Type of Anatomical Structure
3/4 Specific Anatomical Structure
5/6 Level
7 Severity Score
 1 Body Region
123456.7

1 Head 6 Spine
2 Face 7 Upper Extremity
3 Neck 8 Lower Extremity
4 Thorax 9 Unspecified
5 Abdomen
2 Type of Anatomic Structure
123456.7
1 Whole Area
2 Vessels
3 Nerves
4 Organs (inc. muscles/ligaments)
5 Skeletal (inc. joints)
6 Loss of Consciousness (head only)
 3/4 Specific Anatomic Structure
123456.7
Whole Area Head - Loss of Consciousness (LOC)
02 Skin Abrasion 02 Length of LOC
04 Contusion 04-08 Level of Consciousness
06 Laceration 10 Concussion
08 Avulsion
10 Amputation Spine
20 Burn 02 Cervical
30 Crush 04 Thoracic
40 Degloving 06 Lumbar
50 Injury - NFS
60 Penetrating Vessels, Nerves, Organs, Bones, Joints
These are all assigned consecutive
two digit numbers beginning with 02
 5/6 Level
123456.7

Specific Injuries are assigned

consecutive two-digit numbers
beginning with 02
Fractures, rupture, laceration, etc
 Injury Severity
Abbreviated Injury Score
1 Minor
2 Moderate
3 Serious
4 Severe
5 Critical
6 Maximum
 AIS
AIS Example
1 superficial laceration
2 fractured sternum
3 open fracture of humerus
4 perforated trachea
5 ruptured liver with tissue loss
6 total severance of aorta
AIS – Threat to life
AIS % prob. of death
1 0
2 1–2
3 8 – 10
4-5 50 – 50
6 100
Organ injuries
Skeletal injuries
Measures of Injury Severity
• Maximum Abbreviated Injury Score (MAIS)
- Maximum AIS for an occupant or body region
- Frequently used for assessing overall severity
- Non-linear relationship with the probability of death

Body region AIS MAIS

Head 4
Neck 2
Thorax 5 5
Abdomen 1
Lower limb 3
Injury Severity Score (ISS)
Gives a better fit between overall severity &
probability of survival than MAIS

The ISS is the sum of the squares of the

highest AIS code in each of the three most
severely injured ISS body regions.

There six ISS body regions.

Six ISS body regions
Head or Neck
Face
Thorax
Abdominal or Pelvic content
Extremities or Pelvic Girdle
External
Injury Severity Score (ISS)
Body region AIS MAIS
Head 4
Neck 2
Thorax 5 5
Abdomen 1
Lower limb 3
ISS = (5x5)+(4x4)+(3x3) = 50
ISS range 0 – 75
Proviso : AIS 6 = ISS 75
Linear scale 0 - 75
 Examples

Uses
of
Injury Severity Data
• Eppinger et al (1999) (NHTSA)
• Foret-bruno et al (1998) 42nd STAPP
• Mertz
(1971??)