Multiple injuries in peacetime and wartime estimate of severity of injury by the injury severity score and polytraumaschlussel

Abstract

Objective: To compare the Injury Severity Score (ISS) and Polytraumaschlussel (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.