title: Update on the definition of polytrauma.
abstract: OBJECTIVE
  The definition and use of the term "polytrauma" is inconsistent and lacks validation. This article describes the historical evolution of the term and geographical differences in its meaning, examines the challenges faced in defining it adequately in the current context, and summarizes where the international consensus process is heading, in order to provide the trauma community with a validated and universally agreed upon definition of polytrauma.
  
  
  CONCLUSIONS
  A lack of consensus in the definition of "polytrauma" was apparent. According to the international consensus opinion, both anatomical and physiological parameters should be included in the definition of polytrauma. An Abbreviated Injury Scale (AIS) based anatomical definition is the most practical and feasible given the ubiquitous use of the system. Convincing preliminary data show that two body regions with AIS >2 is a good marker of polytrauma-better than other ISS cutoffs, which could also indicate monotrauma. The selection of the most accurate physiological parameters is still underway, but they will most likely be descriptors of tissue hypoxia and coagulopathy.
authors.affiliation: Division of Surgery, Department of Traumatology, John Hunter Hospital and the University of Newcastle, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia. nerida.butcher@gmail.com.
authors.forename: N E
authors.initials: NE
authors.lastname: Butcher
authors.affiliation: Division of Surgery, Department of Traumatology, John Hunter Hospital and the University of Newcastle, Locked Bag 1, Hunter Region Mail Centre, Newcastle, NSW 2310, Australia. zsolt.balogh@hnehealth.nsw.gov.au.
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Balogh
keywords: Definition; Polytrauma
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