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AAST Bladder Injury Scale AAST Bowel Injury Scale AAST Cardiac Injury Scale AAST Diaphragm Injury Scale AAST Hepatic Injury Scale AAST Kidney Injury Scale AAST Lung Injury Scale AAST Pancreatic Injury Scale AAST Rectal Injury Scale AAST Splenic Injury Scale AAST Vascular Injury Scale ABC Score (Massive Transfusion)ACS COT Field Triage Guidelines ATLS Hemorrhagic Shock Classification Abbreviated Injury Scale (AIS)Ankle-Brachial Index (ABI) in Trauma Base Deficit in Trauma Brain Injury Guidelines (BIG) Score Cardiac Wound Index Chest Trauma Score (CTS)Damage Control Decision Score (DCDS)Denver Criteria (BCVI)Esophageal Perforation Severity Score (PSS)Expanded Denver Criteria (BCVI)Flint Colon Injury Scale Frailty Index in Trauma (mFI-5)Geriatric Trauma Outcome Score (GTOS)Hard Signs of Vascular Injury Checklist Hemorrhage Control Decision Aid (Wound Packing vs. Tourniquet)ICP-based Cerebral Perfusion Pressure (CPP) Calculator Injury Severity Score (ISS)Injury Severity Score — Age-adjusted (ISS-Age)Lethal Triad / Trauma Triad of Death Calculator Limb Salvage Index (LSI)Mangled Extremity Severity Score (MESS)Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure (MGAP)Memphis Criteria (BCVI)Modified Shock Index (MSI)Nerve Injury, Ischemia, Soft-tissue, Skeletal Injury, Shock, Age (NISSSA)New Injury Severity Score (NISS)Open Abdomen Classification (Björck)Pediatric Trauma Score (PTS)Pelvic Trauma Hemorrhage Risk Score Penetrating Abdominal Trauma Index (PATI)Physiologic Extreme Emergency in Trauma (FEET)Predictive Salvage Index (PSI)REBOA Zone Selection Guide Resuscitative Thoracotomy Indications (EAST/WTA Guidelines)Revised Trauma Score (RTS)RibScore Shock Index (SI)TASH Score TRISS Index Thoracic Trauma Severity Score (TTS)Tile Classification of Pelvic Fractures Trauma and Injury Severity Score — Pediatric (PTS)Young–Burgess Pelvic Fracture Classification

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Esophageal Perforation Severity Score (PSS)

Thoracic Severity Scoring

Clinical Indicators

Select Findings

Assess clinical markers to determine the severity and management pathway for esophageal perforation.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

When to Use PSS

Suspected or confirmed esophageal perforation (traumatic or iatrogenic)

Post-endoscopy complications (EGD, dilation, stent placement)

Penetrating neck or thoracic trauma involving esophagus

Boerhaave syndrome (spontaneous rupture after vomiting)

Delayed diagnosis of mediastinal infection from esophageal leak

Evaluation prior to surgical vs non-operative management decision

Clinical Context of Use

Scenario	Typical Risk	Clinical Concern
Iatrogenic endoscopy injury	Variable	Early recognition improves survival
Blunt chest trauma	Low–moderate	Often delayed diagnosis
Penetrating trauma	High	Associated vascular/airway injury
Boerhaave syndrome	High	Rapid mediastinitis and sepsis
Delayed presentation >24h	Very high	Increased mortality risk

Limitations

No universally standardized validated scoring system (institutional adaptation used)

Dependent on imaging availability (CT contrast, esophagography)

Clinical deterioration may precede score change

Does not fully capture mediastinal sepsis severity

Limited pediatric validation data

High-Stakes Injury

Esophageal perforation carries mortality rates up to 20–40% if treatment is delayed beyond 24 hours due to rapid progression to mediastinitis and sepsis.

Last Comprehensive Review: 2026

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