Abbreviated Injury Scale (AIS)

Position Statement

Association for the Advancement of Automotive Medicine (AAAM)

WHEREAS the Abbreviated Injury Scale (AIS©) incorporates standardized current medical terminology providing an internationally accepted tool for rating injury severity, and

WHEREAS current AIS users include: health organizations (for clinical trauma management, outcome evaluation and for case mix adjustment purposes), motor vehicle crash investigators (for identification of mechanism of injury and improvements to vehicle design), and researchers (for epidemiological studies and systems development), all of which may influence public policy, and

WHEREAS AIS is the basis for the Injury Severity Score (ISS) calculation for the patient with multiple injuries, and

WHEREAS AIS 2015, which is the latest version, incorporates the needs of its users and the current status of traumatic injury diagnosis and documentation,

BE IT RESOLVED that the AAAM recommends that all countries use and encourage the use of the AIS 2015 for all injury research related activities.

Rationale

The Abbreviated Injury Scale (AIS) is used by automotive injury research and policy experts across the world. AIS is an anatomically based, consensus derived, global severity scoring system that classifies an individual injury by body region according to its relative severity on a 6 point scale (1=minor and 6=maximal).

The Maximum Abbreviated Injury Scale (MAIS) is a globally accepted and widely used trauma scale used by medical professionals. It provides an objective and reliable basis for data collection and international comparisons. The injury score is determined at the hospital with the help of a detailed classification key. The MAIS is the highest (i.e. most severe) AIS code in a patient with multiple injuries.

The Injury Severity Score (ISS) is widely used within the clinical setting and has become an integral part of all trauma registry-based severity assessment tools. The ISS is the sum of the squares of the highest AIS score in three different body regions. An ISS score greater than 15 is used as a cutoff for serious injury.

While a common definition of fatal injury in road traffic crashes has been in place for many years, no common definition of serious injury has been available until recently. Because of the difficulties associated with standardizing an operational definition for non-fatal injuries, the European Union is working to mandate its 28-country members to use MAIS3+ as the indicator for such metric.

In order to start to address these issues the European Commission and the High Level Group on Road Safety agreed on a common definition of serious injuries in January 2013. Serious injury is newly defined as an injury level of MAIS 3+ which was recommended by EU projects such as SafetyNet and international organizations such as the International Transport Forum.

Adopting the widespread use of the AIS 2015 will support worldwide traffic safety initiatives such as the UN Sustainable Development Goal (SDG 3.6), which sets a target to “Halve the number of global deaths and injuries from road traffic accidents.”

AAAM encourages the World Health Organization (WHO) and other international institutions to embrace AIS and its derivatives as operational definition for fatal and non-fatal injuries and offers technical assistance to researchers, policy makers and all others interested to learn and adapt the AIS metric to their environment.

AAAM is a non-profit education and research organization. The AIS codebook is protected by copyright and any revenue generated through AIS training or sales are reinvested in enhancing AIS and the mission of AAAM.

Research

The Association for the Advancement of Automotive Medicine. Abbreviated Injury Scale (AIS) 2005 – Update 2008. Barrington, IL: The Association for the Advancement of Automotive Medicine; 2008.

The Association for the Advancement of Automotive Medicine. Abbreviated Injury Scale (AIS) 2015. Chicago, IL: The Association for the Advancement of Automotive Medicine; 2016.

European Commission, Serious Injuries, European Commission, Directorate General for Transport, September 2015.

Cox S, Currell A, Harriss L, et al. Evaluation of the Victorian state adult pre-hospital trauma triage criteria. Injury 2012;43: 573e581.

Lossius HM, Rehn M, Tjosevik KE, Eken T. Calculating trauma triage precision: effects of different definitions of major trauma. J Trauma Manag Outcomes 2012;6:9.

American College of Surgeons Committee on Trauma. Resources for Optimal Care of the Injured Patient. Chicago, IL: American College of Surgeons Committee on Trauma; 2006.

Palanca S, Taylor DM, Bailey M, Cameron PA. Mechanisms of motor vehicle accidents that predict major injury. Emerg Med 2003;15:423e428.

Ryan JM, Gaudry PL, McDougall PA, McGrath PJ. Implementation of a two-tier trauma response. Injury 1998;29: 677e683.

National Center for Injury Prevention and Control. Recommendations from the Expert Panel: Advanced Automatic Collision Notification and Triage of the Injured Patient. Atlanta, GA: Centers for Disease Control and Prevention; 2008.