The current method of assessing the severity of injury is by visual inspection and clinical examination by the first responder at the site of presentation of the injured subject. This is a subjective evaluation conditioned by the level of medical or first-aid training of the responder, which may vary from complete lack of training or experience to a high level of training and experience in emergency medicine and rescue work. However, it is difficult even for trained physicians to make a precise evaluation of the severity of injury of victims of mass-casualty incidents (Ashkenazi et al. Prehospital Disaster Med. 2006 21:20-23).
In everyday cases of injury, the injured subject will be brought at the slightest suspicion of non-triviality to a hospital or trauma center. In mass casualty situations such as accidents, natural disasters and hostile acts such as bomb explosions where a large number of people, typically in excess of 10, are injured, this is not feasible because of lack of immediately available resources. Thus, triage, defined as prioritizing of the injured survivors for treatment or transport to treatment facilities in order to obtain the best overall outcome in terms of survival or the avoidance of permanent disability, is applied. The more accurate the triage, the higher the survival rate and the lower the number of complications leading to prolonged hospitalization or lifelong disability.
Injury severity scoring, as exemplified by the Injury Severity Score (ISS), which is standard practice at many centers for the treatment of trauma, is based on an anatomic examination. It estimates the severity of the most severe injury to each part of the body. The procedure takes time and does not take into account changes in the patient's physiological state including those due to internal bleeding, changes in fluid balance and activation of the blood clotting system. Furthermore, injury severity scoring systems do not take into account the progression of such changes during the time interval from the injury to the moment of scoring.
The present invention remedies defects of injury severity scoring by measuring the concentration in a bodily fluid of a biomarker that reflects the body's response to injury and hence reflects the change in the condition of the patient.