Association of Injury Severity Score to Mortality and Length of Hospital Stay in Polytrauma Patients
Submission: 05 April 2026 | Acceptance: 20 May 2026 | Publication: 15 June 2026
1Dr. Gulsharif, 2Umar Shah, 3Rizwan Ali, 4Ali Raza, 5Hadi Safdar, 6Khizar Hayat
1Assistant Professor, Surgery, MTI Lady Reading Hospital, Peshawar
2PIMS Islamabad
3PIMS Islamabad
4PIMS Islamabad
5PIMS Islamabad
6PIMS Islamabad
Corresponding Author: Dr. Gulsharif
Assistant Professor, Surgery, MTI Lady Reading Hospital, Peshawar
Abstract
Background
Polytrauma is an important cause of morbidity and mortality internationally and is frequently caused by road traffic accidents, falls from height and industrial injuries. Accurate assessment of injury severity is important to help predict injury outcomes, best utilize resources, and help optimize trauma management strategies. The Injury Severity Score (ISS) is a commonly accepted scoring system that is used to measure the overall severity of injuries in polytrauma patients. Despite evidence of its use, there is still a need for the evaluation of the association of ISS with clinically relevant outcomes, especially mortality and length of hospitalization, in diverse patient populations.
Objective
The main aim of this study was to examine the correlation between the ISS and mortality in the polytrauma patient. The secondary objective was to determine the correlation of ISS and hospital stay and gain information about resource utilization and prognosis in trauma care.
Methodology
A prospective observational study was performed in the Lady Reading Hospital, Peshawar between August 2024 and August 2025. Polytrauma patients aged 18 years and above, presenting with injuries of multiple anatomic regions to the emergency department, were considered. Patients who had isolated injuries, incomplete records or pre-existing terminal illnesses were excluded. Demographic data, clinical parameters, ISS, duration of hospital stay, and mortality outcome were registered. Statistical analysis was done to analyze the relation between ISS and mortality and hospital stay, correlation analysis and regression analysis.
Results
A total of patients that met the inclusion criteria were enrolled. The mean ISS was found to be proportional to mortality rates thus showing the significant positive correlation. Higher ISS was also found to be associated with a longer length of hospital stay reflecting resource utilization severity of injury. Subgroup analysis showed that patients with ISS above the cutoff of 25 had significantly higher mortality and longer hospitalization than those with low scores. These findings demonstrate its predictive validity in clinical decision-making and outcome assessment in polytrauma management.
Keywords
Injury Severity Score, Polytrauma, Mortality, Hospital stay, Trauma surgery