TISS is based on the premise that, regardless of the diagnosis causing critical illness, the physiological derangements requiring therapeutic support result from the severity of the illness. Further, many critically ill patients lack a diagnosis upon admission and, sometimes, even at the time of their death from multiple organ failure.
Two major assumptions are required when using TISS. First, most or all interventions listed must be available within a particular hospital. Otherwise, the TISS score may be artificially reduced. Second, therapeutic interventions should be initiated for medically justifiable reasons and not because they generate additional income for the physician or hospital.
TISS is a compilation of monitoring and therapeutic modalities, each of which is assigned a weighted score from one to four points depending on their intensity ( Table 1). The sum of all the points for all the interventions applied to an individual patient is the TISS score.
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