The Evolution of Trauma Grading Systems

The evolution of trauma grading systems can be traced back to the development of the Abbreviated Injury Scale (AIS) in 1971, initially created for automotive safety improvements. This standardized approach allowed for a universal language to classify injury severity across different body regions. Building on the AIS, the Injury Severity Score (ISS) was introduced in 1974, which assessed overall injury severity by aggregating scores from various body regions. The introduction of the Abdominal Trauma Index (ATI) in 1981 focused specifically on abdominal injuries, laying the groundwork for the more standardized AAST Organ Injury Scale (AAST-OIS), which emerged as a gold standard in organ injury grading and has been widely implemented both in the U.S. and internationally.