Splenic Injury Grading (AAST 2018) — free guideline decision tool
This tool grades splenic injury I–V using the AAST 2018 Organ Injury Scale, which for the first time incorporates vascular injury (pseudoaneurysm/AVF) and active bleeding into the imaging criteria.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Most severe imaging/operative finding | Grade I: subcapsular hematoma < 10% / laceration < 1 cm deep / capsular tear |
|---|
→AAST splenic injuryGrade I
- Grade：Grade I (the 2018 version incorporates vascular injury: pseudoaneurysm/AVF and active bleeding)
- Management direction：Usually nonoperative management (NOM): monitoring, serial exams and hemoglobin, premised on hemodynamic stability
- Multiple injuries：Multiple injuries to the same organ may upgrade by one grade, up to grade III
| Most severe imaging/operative finding | Grade V: shattered spleen / vascular injury with active bleeding extending beyond the spleen into the peritoneum |
|---|
→AAST splenic injuryGrade V
- Grade：Grade V (the 2018 version incorporates vascular injury: pseudoaneurysm/AVF and active bleeding)
- Management direction：Hemodynamically unstable or grade IV–V active bleeding → angioembolization or surgery (splenorrhaphy/splenectomy)
- Multiple injuries：Multiple injuries to the same organ may upgrade by one grade, up to grade III
Common questions
What is Splenic Injury Grading (AAST 2018)?
This tool grades splenic injury I–V using the AAST 2018 Organ Injury Scale, which for the first time incorporates vascular injury (pseudoaneurysm/AVF) and active bleeding into the imaging criteria.
How is Splenic Injury Grading (AAST 2018) calculated? What is the core formula?
Grade by the most severe finding (subcapsular/intraparenchymal hematoma size, laceration depth, vascular injury). I–II usually NOM; III NOM ± embolization; IV–V or instability → embolization/surgery.
When is Splenic Injury Grading (AAST 2018) used?
Use in blunt abdominal trauma to assign a splenic injury grade and frame management — nonoperative monitoring, angioembolization, or surgery — always interpreted against hemodynamic stability.
What are the key clinical points for Splenic Injury Grading (AAST 2018)?
Management hinges on hemodynamic stability and overall injury burden, not the grade alone — operative indications are instability, peritonitis, or ongoing bleeding. (original synthesis · not guideline verbatim) Multiple injuries to the same organ may upgrade by one grade, up to grade III. The 2018 update folds vascular lesions into the scale, capturing pseudoaneurysm/AVF and active intracapsular bleeding.
What are the limits and cautions when using Splenic Injury Grading (AAST 2018)?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
How is Splenic Injury Grading (AAST 2018) calculated in practice? Can you show a worked example?
Inputs: Most severe imaging/operative finding Grade I: subcapsular hematoma < 10% / laceration < 1 cm deep / capsular tear → Result: AAST splenic injury Grade I（Grade: Grade I (the 2018 version incorporates vascular injury: pseudoaneurysm/AVF and active bleeding), Management direction: Usually nonoperative management (NOM): monitoring, serial exams and hemoglobin, premised on hemodynamic stability, Multiple injuries: Multiple injuries to the same organ may upgrade by one grade, up to grade III） Inputs: Most severe imaging/operative finding Grade V: shattered spleen / vascular injury with active bleeding extending beyond the spleen into the peritoneum → Result: AAST splenic injury Grade V（Grade: Grade V (the 2018 version incorporates vascular injury: pseudoaneurysm/AVF and active bleeding), Management direction: Hemodynamically unstable or grade IV–V active bleeding → angioembolization or surgery (splenorrhaphy/splenectomy), Multiple injuries: Multiple injuries to the same organ may upgrade by one grade, up to grade III）
Run Splenic Injury Grading (AAST 2018) now
This tool grades splenic injury I–V using the AAST 2018 Organ Injury Scale, which for the first time incorporates vascular injury (pseudoaneurysm/AVF) and active bleeding into the imaging criteria.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.