Its use as a formal definition however has not been established according to the traditional rules of evidence. 15Īn Injury Severity Score (ISS) greater than 15 is a frequently used definition for both polytrauma and the interchangeably used terms of severely injured and major trauma. 5–14 Illustrating this fact, we conducted a recent study based on subjective assessments and found that trauma surgeons do not agree on the definition of polytrauma, with subjective definitions differing both within and across institutions. 1–4 While polytrauma patients are generally regarded to be the most severely injured patients with two or more significant injuries, the use of the term both clinically and in the literature is inconsistent. The current terminology surrounding the severely injured lacks both clarity and consensus, particularly in relation to the term polytrauma.
In the adjusted analyses, patients with 2 × AIS score > 2 had twice the odds of being admitted to the ICU compared with those without 2 × AIS score > 2 (odds ratio, 2.5 95% confidence interval, 2.2–2.8) and 1.7 times the odds of dying (95% CI, 1.4–2.0 p 2 also had a mean difference of 1.5 days longer stay in the hospital compared with those without 2 × AIS score > 2 (95% CI, 1.4–1.7) and 1.6 days longer ICU stay (95% CI, 1.4–1.8 p 2 had higher mortality, more frequent ICU admissions, and longer hospital and ICU stay than those without 2 × AIS score > 2 and represents a superior definition to the definitions for polytrauma currently in use. We then undertook regression analyses (logistic regression for binary outcomes and linear regression for hospital and ICU LOS) to compare outcomes for patients with and without 2 × AIS score > 2, adjusting for sex and age categories. We compared demographic characteristics and outcomes between patients with ISS greater than 15 who did and did not meet the 2 × AIS score > 2 definition. Age and sex were obtained in addition to outcomes of ISS, hospital length of stay (LOS), intensive care unit (ICU) admission, ICU LOS, and mortality. Patients injured between 20, with complete documentation of AIS by New South Wales Trauma Registry and 16 years and older were selected. We hypothesized that patients defined by the 2 × AIS score > 2 cutoff have worse outcomes and use more resources than those without 2 × AIS score > 2 and that this would therefore be a better definition of polytrauma. This study aimed to validate this definition on larger data set. A pilot validation recommended defining polytrauma as patients with an Abbreviated Injury Scale (AIS) score greater than 2 in at least two Injury Severity Score (ISS) body regions (2 × AIS score > 2).
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