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The Injury Severity Score (ISS) is a standard aggregate indicator of theoverall severity of multiple injuries to the human body. This score iscalculated by summing the squares of the three highest values of theAbbreviated Injury Scale (AIS) grades across six body regions of a traumavictim. Despite its widespread usage over the past four decades, little isknown in the (mostly medical) literature on the subject about the axiomatic andstatistical properties of this quadratic aggregation score. To bridge this gap,the present paper studies the ISS from the perspective of recent advances indecision science. We demonstrate some statistical and axiomatic properties ofthe ISS as a multicrtieria aggregation procedure. Our study highlights someunintended, undesirable properties that stem from arbitrary choices in itsdesign and that call lead to bias in its use as a patient triage criterion.

On Some Statistical and Axiomatic Properties of the Injury Severity Score