Stoner H B, Heath D F, Yates D W, Frayn K N
J R Soc Med. 1980 Jan;73(1):19-22.
Attempts have been made to improve the Injury Severity Score (ISS) system of Baker et al. (1974) using plasma lactate data obtained from 277 patients shortly after injury and before treatment. The ISS is based on the Abbreviated Injury Scale (AIS) values of the individual injuries, being the sum of the squares of the values for the three most severely injured regions. Log (plasma lactate concentration) is positively related to ISS over its whole range. It was not possible to vary the AIS values, either on clinical grounds or using a computer, in such a way that the variance of the log (plasma lactate concentration) about its regression line with ISS was significantly reduced. With a score based on the sum of the squares of the AIS values for all the patient's injuries, some improvement to the AIS values could be made but it was not statistically significant. At the present time Baker's ISS method would seem to be the best way of grading injuries for acute studies.
人们尝试利用277名患者受伤后不久且在治疗前获得的血浆乳酸数据来改进贝克等人(1974年)的损伤严重度评分(ISS)系统。ISS基于各个损伤的简明损伤定级(AIS)值,即三个最严重损伤区域的值的平方和。对数(血浆乳酸浓度)在其整个范围内与ISS呈正相关。无论是基于临床理由还是使用计算机,都无法以显著降低对数(血浆乳酸浓度)关于其与ISS回归线的方差的方式改变AIS值。对于基于患者所有损伤的AIS值平方和的评分,可以对AIS值进行一些改进,但在统计学上并不显著。目前,贝克的ISS方法似乎是急性研究中损伤分级的最佳方式。