[Hospital management and short-term outcome of the severely injured: Lausanne experience]

Published online: Mar 27 1993

P Zangger, F Chevalley, and O Moeschler.

Service Universitaire d'Orthop├ędie et de Traumatologie de l'Appareil Moteur, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Suisse.


Several physiological and anatomical methods of scoring severely injured patients have been developed since the 1970s, based on very large series of patients. In this study, 59 patients are assessed by the ISS (Injury Severity Score) and the RTS (Revised Trauma Score). The mean ISS is 28, and the mean RTS is 6; the overall evolution shows a 42.4% mortality. Analysis by the TRISS method shows 12 out of 18 "unexpected" deaths, the majority of which can be explained by the fact that the ISS underestimates severe neurological trauma, and that the RTS is not consistently obtained in the early patient notes in our emergency care system.