A prospective study was undertaken over a 2 1/2 year period (July 1, 1985-December 31, 1987) to determine the value of a prospective anatomical severity score ["Estimated" Injury Severity Score (EISS)], in combination with age, for early risk assessment. Five hundred ninety-two blunt trauma patients were used to develop a predictive model of mortality through a logistic regression. The model was validated using 216 patients; a high degree of agreement (Kappa 0.73) was found. When isolated head injuries were removed from the model and validation groups, the Kappa increased to 0.80. Prospective anatomical scoring in combination with age may help to identify high-risk trauma patients early during their care.