The Head Injury Severity Scale (HISS): a practical classification of closed-head injury.
The authors introduce a two-dimensional scale for rating closed-head injury, the Head Injury Severity Scale (HISS). This system is based on a five-interval severity classification (minimal through critical), determined primarily by the initial post-resuscitation Glasgow Coma Scale score. The second dimension is predicated on the presence or absence of complications, appropriate for each severity interval. The outcomes of almost 25,000 patients with head injury encountered at our institution over a 7-year period were evaluated. We discovered that adding a complication dimension to each severity category resulted in significant outcome differences and effectively divided patients into groups with very different risks, prognosis and treatment requirements. The HISS is proposed as a framework on which further research can be done to guide care to predict outcome and to perform audits on head-injured patients.
Stein
S C
SC
Division of Neurosurgery/Department of Surgery, Cooper Hospital/University Medical Center, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden 08103, USA.
Spettell
C
C
D001925:Brain Damage, Chronic / Q000145:classification / Q000175:diagnosis / Q000534:rehabilitation; D015600:Glasgow Coma Scale; D016489:Head Injuries, Closed / Q000145:classification* / Q000175:diagnosis / Q000534:rehabilitation; D006801:Humans; D015601:Injury Severity Score; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome