Intensive Care Medicine

, Volume 21, Issue 7, pp 606–609 | Cite as

The abbreviated injury scale as a predictor of outcome of severe head injury

  • A. D. Walder
  • P. M. Yeoman
  • A. Turnbull
Brief Report



This study examined the correlation between the worst abbreviated injury scale 1990 (AIS) intracranial severity score and outcome following severe head injury.


The initial CT scans of 109 severly head injury patients were examined by a neuroradiologist and classified according to the worst applicable intracranial severity code from the AIS. This score was then correlated with the glasgow outcome scale (GOS) at 6 months. For comparison, the GOS was also correlated with the diffuse injury scale (DIS) described by L.F. Marshall et al. [5], the worst post-resuscitation Glasgow coma score (GCS) in the first 24 h, and the head injury outcome prediction tree described by Choi et al. [1].


Our results show Spearman rank correlation coefficients of 0.58 (p<0.001), 0.47 (p<0.001), 0.45 (p<0.001), and 0.31 (p<0.01) for the correlation between the AIS, prediction tree, DIS, and GCS respectively and the GOS. Independent outcome (i.e. GOS good or moderate) was strongly predicted by an AIS of 3 or less (positive predictive value 95%, specificity 98%, sensitivity 40%, likelihood ratio 25∶1). Death or vegetative survival was less strongly predicted in patients with an AIS of 5 (positive predictive value 71%, specificity 75%, sensitivity 67%, likelihood ratio 2.7∶1).


The AIS, based on initial CT scan, provides useful prognostic information in patients with severe head injury.

Key words

Severe head injury Outcome Computerised tomographic scan Abbreviated injury scale 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Choi SC, Muizelaar JP, Barnes TY et al (1991) Prediction tree for severely head injured patients. J Neurosurg 75:251–255PubMedGoogle Scholar
  2. 2.
    Choi SC, Narayan R, Anderson R et al (1988) Enhanced specificity of prognosis in severe head injury. J Neurosurg 69:381–385PubMedGoogle Scholar
  3. 3.
    Choi SC, Ward JD, Becker DP (1983) Chart for outcome prediction in severe head injury. J Neurosurg 59:294–297PubMedGoogle Scholar
  4. 4.
    Clifton G, Grossman R, Mekela M et al (1980) Neurological course and correlated computerised tomography findings after severe closed head injury. J Neurosurg 52:611–624PubMedGoogle Scholar
  5. 5.
    Marshall L, Eisenberg H, Jane J et al (1991) A new classification of head injury based on computerised tomography. J Neurosurg 75:S14-S20Google Scholar
  6. 6.
    Narayan R, Greenberg R, Miller D et al (1981) Improved confidence of outcome prediction in severe head injury. J Neurosurg 54:751–762PubMedGoogle Scholar
  7. 7.
    American Association for Automotive Medicine (1990) The abbreviated injury scale — 1990 revision. Des Plaines, IllinoisGoogle Scholar
  8. 8.
    Baker S, O'Neill B, Haddon W et al (1974) The injury severity score: a method for describing patients with multiple injuries and evaluating emergency care. J Trauma 14:187–196PubMedGoogle Scholar
  9. 9.
    Champion H, Sacco W, Hunt T (1983) Trauma severity scoring to predict mortality. World J Surg 7:4–11PubMedGoogle Scholar
  10. 10.
    Copes W, Champion H, Sacco W et al (1988) The injury severity score revisited. J Trauma 28:69–77PubMedGoogle Scholar
  11. 11.
    Gennarelli TA (1980) Analysis of head injury severity by AIS-80. Proceedings of American Association for Automotive Medicine, Rochester, NYGoogle Scholar
  12. 12.
    Genarelli TA, Champion HR, Sacco WJ et al (1988) Mortality of patients with head injury and extracranial injury treated in trauma centres. J Trauma 29:1193–1201Google Scholar
  13. 13.
    Jennet B, Bond M (1975) Assessment of outcome after severe brain damage: a practical scale. Lancet I:480–484Google Scholar
  14. 14.
    Sackett DL, Haynes RB, Guyatt GH, Tugwell P (1985) The interpretation of diagnostic data. In: Clinical epidemiology: a basic science for clinical medicine. Little, Brown & Co, Boston, pp 119–139Google Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • A. D. Walder
    • 1
  • P. M. Yeoman
    • 2
  • A. Turnbull
    • 3
  1. 1.Queens Medical CentreUniversity Department of AnaesthesiaNottinghamUK
  2. 2.Department of Intensive Care, Adult Intensive Care UnitQueens Medical CentreNottinghamUK
  3. 3.Department of RadiologyDerby Royal InfirmaryDerbyUK

Personalised recommendations