This is a numeric approach to partial differentiation of the equation used. The method consists in the calculation of the uncertainty range around the nominal value. Injury and physiological derangement evaluation The medical data collected in the database are selected to provide a clear correlation between the trauma’s dynamic and the injury’s localization Inhibitors,research,lifescience,medical and severity. The main

information coming from the EMS (e.g. Glasgow Coma Scale, blood pressure, and intubation) and ER/ICU (e.g. diagnostics), the AIS and ISS scores, the EMTRAS and the Computed Tomography information, are the scores and data chosen for the previous aims. The AIS was developed by the Automotive Committee On Medical Aspects of Automotive Safety in 1971 [29]. The last revision of the score is the AIS 2005, updated in 2008. Because the different AIS versions are not always compatible, injury severity scoring tools using the new AIS should be compared to those using previous versions in terms of score and predictive

performance Inhibitors,research,lifescience,medical [30]: Carroll et al. show a reduction in traumatic brain injury (TBI) AIS when recorded using the 2005 revision versus the 1998 one [31]. For this reason, the In-SAFE database includes the AIS 2005 and AIS 1998 codifications, in order to asses differences Inhibitors,research,lifescience,medical in trauma severity classifications, and to allow the comparison with other databases using both revisions of the AIS. The ISS was introduced by Baker in 1974 to classify the severity of traumas involving lesions in more than one of the AIS regions. The score is calculated summing the square of the three highest AIS of three different body regions. No more than one AIS can be taken from a

single region [30,31]. Inhibitors,research,lifescience,medical [30,31]. If a lesion is graded as 6, the ISS is automatically calculated as 75. This choice put greater attention on the multiplicity of trauma injury but at the same moment it can overlook multiple lesions suffered Inhibitors,research,lifescience,medical by the same part of the body. For this reason in 1997 Osler et al. developed the NISS, which is calculated summing the square of the 3 highest AIS, without any regard to the body region [32,33]. Dipeptidyl peptidase The authors affirm the superiority of the NISS to the ISS to predict the outcome of the trauma patient, and this conclusion is supported by Lavoie et al. [34]. In addition, for research purposes, the EMTRAS score, a new trauma score developed in Germany in 2009 that is calculated by using the age of the patient, the on-scene GCS, the Base excess, and the Prothrombin Time at the ER [35], has been added to the In-SAFE database. Drug and alcohol abuse are a major cause of loss of life, threatening injury in motor vehicle accidents, both in the US and in Europe [36,37]. Drugs test includes ethanol, cannabis, High Content Screening cocaine, amphetamine, benzodiazepine, barbiturate, and opioids dosage, collected upon admission in the ER, and recorded in In-SAFE.