Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep 4;14(17):6259.
doi: 10.3390/jcm14176259.

Evaluation of Traumatic Brain Injury Severity Using the Abbreviated Injury Scale and the Injury Severity Score: A Retrospective Study in Two Eastern European Centers

Iulia-Maria Vadan  1   2 , Diana Grad  2 , Stefan Strilciuc  2   3 , Alina Vasilica Blesneag  1   2   4 , Marcin Michalak  5 , Vitalie Vacaras  1   2   4 , Adina Stan  1   2   4 , Dafin F Muresanu  1   2   4
Affiliations

Evaluation of Traumatic Brain Injury Severity Using the Abbreviated Injury Scale and the Injury Severity Score: A Retrospective Study in Two Eastern European Centers

Iulia-Maria Vadan et al. J Clin Med. .

Abstract

Introduction: Traumatic brain injury (TBI) is a significant global public health issue, with long-term impacts on patients. This study examines the relationship between TBI severity, as measured by the Abbreviated Injury Scale (AIS) and the Injury Severity Score (ISS) at admission, and various sociodemographic, clinical, and injury-related factors. Methods: We conducted a retrospective analysis using data from 164 adult TBI patients. All were admitted between March 2020 and June 2023 to two Eastern European tertiary hospitals. Variables included sex, age, education, employment, marital status, injury type and cause, place of injury, and clinical measures such as the Marshall score, AIS, and ISS. Statistical methods included Pearson's Chi-squared, Fisher's exact, Spearman correlation, Wilcoxon, and Kruskal-Wallis tests. Results: Most patients were male (65.9%), retired (59.8%), and urban residents (73.8%), with a mean age of 64.98 years. The most frequent mechanism of injury was falls (76.2%), typically occurring at home (61%). The predominant injury type was closed head trauma (93.3%). Most patients had mild AIS scores (75%), and the mean ISS was 6.52 (SD: 4.55). Statistically significant group differences were found for AIS among categories of Modified Marshall Score, injury type, and education categories and for ISS among categories of the Modified Marshall Score, injury type, cause and place of injury, employment status, and sex. No significant correlations were found between AIS or ISS and age or hospital length of stay. Conclusions: AIS is more anatomically focused. ISS reflects broader systemic injury patterns and is more influenced by contextual factors. These findings are particularly relevant for the Eastern European population and can help develop better healthcare policies for the region.

Keywords: AIS; ISS; abbreviated injury scale; eastern Europe; injury severity scale; modified Marshall score; neurotrauma epidemiology; retrospective study; trauma severity scoring; traumatic brain injury.

PubMed Disclaimer

Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
(A,B) Mean ISS for categorical variables. Error bars represent standard error of the mean ISS.
Figure 1
Figure 1
(A,B) Mean ISS for categorical variables. Error bars represent standard error of the mean ISS.
Figure 2
Figure 2
(A,B) Percentages for categorical variables by AIS categories.
Figure 2
Figure 2
(A,B) Percentages for categorical variables by AIS categories.
See this image and copyright information in PMC

References

    1. Ogonah M.G.T., Botchway S., Yu R., Schofield P.W., Fazel S. An Umbrella Review of Health Outcomes Following Traumatic Brain Injury. Nat. Ment. Health. 2025;3:83–91. doi: 10.1038/s44220-024-00356-5. - DOI - PMC - PubMed
    1. Young J.T., Hughes N. Traumatic Brain Injury and Homelessness: From Prevalence to Prevention. Lancet Public Health. 2020;5:e4–e5. doi: 10.1016/S2468-2667(19)30225-7. - DOI - PubMed
    1. Jiang J.-Y., Gao G.-Y., Feng J.-F., Mao Q., Chen L.-G., Yang X.-F., Liu J.-F., Wang Y.-H., Qiu B.-H., Huang X.-J. Traumatic Brain Injury in China. Lancet Neurol. 2019;18:286–295. doi: 10.1016/S1474-4422(18)30469-1. - DOI - PubMed
    1. Ma Z., Hui J., Yang C., Jiang J., Xie L.I., Feng J. In-Hospital Mortality and Risk Factors among Elderly Patients with Traumatic Brain Injury: Protocol for a Systematic Review and Meta-Analysis. BMJ Open. 2023;13:e065371. doi: 10.1136/bmjopen-2022-065371. - DOI - PMC - PubMed
    1. Steyerberg E.W., Wiegers E., Sewalt C., Buki A., Citerio G., De Keyser V., Ercole A., Kunzmann K., Lanyon L., Lecky F., et al. Case-Mix, Care Pathways, and Outcomes in Patients with Traumatic Brain Injury in CENTER-TBI: A European Prospective, Multicentre, Longitudinal, Cohort Study. Lancet Neurol. 2019;18:923–934. doi: 10.1016/S1474-4422(19)30232-7. - DOI - PubMed

LinkOut - more resources