Length of Hospital Stay During Injury

Trauma is a leading cause of morbidity and mortality among individuals under 40 and is the third main cause for death throughout the world.Major trauma is commonly defined using an Injury Severity Score (ISS) threshold of 15. Since this threshold was formulated, there have been significant developments in both the Abbreviated Injury Scale underlying the ISS, and trauma management techniques, both in the preventive and acute-care phases of trauma management. This study assesses whether this ISS threshold is appropriate when evaluating both mortality, and hospital-based indicators of morbidity, in a paediatric population using a large hospital trauma registry. Other registries and datasets using ISS >15 as an inclusion criterion may exclude a substantial body of data relating to significantly morbid trauma patients.The discriminative ability of an ISS threshold in identifying severe injury, however, relies on a meaningful and reproducible definition of ‘severe’ - and this often remains elusive or unstated. Rating the severity of an injury (ie, the gravity of the isolated acute impact of the disease, discounting the effects of comorbidity, complications and management) depends on the exact dimension of the illness being considered, and may refer to a host of parameters including:

• likelihood of death
• likely hospital and other resource requirements
• the cost and complexity of the resources and treatments required
• length of recovery
• likelihood and extent of permanent impairment
• energy dissipation or absorption
• incidence of a particular trauma type and impact on quality of life.

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zeo kemp

Journal co-ordinator

Journal of  Intensive and Critical Care Nursing