🩻 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.
Splenic Injury Grading (AAST 2018)
Most severe imaging/operative finding
When to use
Use in blunt abdominal trauma to assign a splenic injury grade and frame management — nonoperative monitoring, angioembolization, or surgery — always interpreted against hemodynamic stability.
How it works
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.
Key points
- 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.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.