🩻 Splenic Injury Grading (AAST 2018)
UseUse in blunt abdominal trauma to assign a splenic injury grade and frame management — nonoperative monitoring…
SourceKozar RA, et al. Organ injury scaling 2018 update: Spleen, liver, and kidney. J Trauma Acute Care S…
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
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Methodology · worked example, guidelines & full notes
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)
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
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 III: subcapsular hematoma > 50% or ruptured / intraparenchymal hematoma ≥ 5 cm / laceration > 3 cm deep |
|---|
→AAST splenic injuryGrade III
- Grade：Grade III (the 2018 version incorporates vascular injury: pseudoaneurysm/AVF and active bleeding)
- Management direction：Nonoperative management ± angioembolization (especially with vascular injury/contrast extravasation), close monitoring
- Multiple injuries：Multiple injuries to the same organ may upgrade by one grade, up to grade III
| 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
Verification & sources · governance
FAQ
Frequently asked questions
- 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.
- Does Splenic Injury Grading (AAST 2018) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.