Multiple injuries in peacetime and wartime estimate of severity of injury by the Injury Severity Score and Polytraumaschlüssel.

OBJECTIVE

To compare the Injury Severity Score (ISS) and Polytraumaschlüssel (PTS) in patients with multiple peacetime and wartime injuries.

DESIGN

Prospective and retrospective study.

SETTING

General hospital, Croatia.

SUBJECTS

71 patients with multiple injuries admitted between 1 January 1993 and 30 September 1994; 41 had peacetime (road traffic accident) injuries and 30 had been injured in battle.

INTERVENTIONS

ISS and PTS scores.

MAIN OUTCOME MEASURE

Correlation of scores with morbidity and mortality.

RESULTS

All patients with wartime injuries were men, compared with 30/41 (73%) of those with peacetime injuries (p < 0.0001). Those with wartime injuries were slightly but not significant younger (mean 35 years, range 17-69, compared with 44 years, range 17-87). Mortality was higher among those with peacetime injuries, but not significantly so (11/41 compared with 5/30, p=0.39). The two scores correlated well for all injuries (r=0.76), and peacetime (r=0.71) and wartime injuries (r=0.84) separately (all correlations p < 0.0001). In both groups, patients who subsequently died scored significantly higher with both scores (p < 0.001).

CONCLUSIONS

The two scores were equally good at describing the severity of injury, and the likelihood of subsequent death, however the injuries were caused.