AAST Spleen Trauma Grading & Score Calculator
References:
- Zarzaur, B. L., Kozar, R., Myers, J. G., Claridge, J. A., Scalea, T. M., Neideen, T. A., Maung, A. A., Alarcon, L., Corcos, A., Kerwin, A., & Coimbra, R. (2015). The splenic injury outcomes trial: An American Association for the Surgery of Trauma multi-institutional study. The journal of trauma and acute care surgery, 79(3), 335–342. https://doi.org/10.1097/TA.0000000000000782
- AAST (American Association for the Surgery of Trauma) 2018 guideline for splenic injury scoring.
- Organ injury scaling: spleen, liver, and kidney. Moore EE, Shackford SR, Pachter HL, McAninch JW, Browner BD, Champion HR, Flint LM, Gennarelli TA, Malangoni MA, Ramenofsky ML, Trafton PG. J Trauma. 1989 Dec;29(12):1664-6.
- Organ injury scaling: spleen and liver (1994 revision). Moore EE, Cogbill TH, Jurkovich GJ, Shackford SR, Malangoni MA, Champion HR. J Trauma. 1995 Mar;38(3):323-4.
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More about AAST Spleen Trauma Calculator for Splenic Injury Grading
Welcome to our advanced calculator designed to assist healthcare professionals in evaluating spleen injuries in trauma settings. This tool follows the American Association for the Surgery of Trauma (AAST) Spleen Injury Scale, using the 2018 revision criteria to deliver a standardized, imaging-based grading system. Although this calculator is independent and not officially endorsed by AAST, it has been developed with high fidelity to the published AAST injury grading guidelines, ensuring a reliable and consistent assessment experience for radiologists, trauma surgeons, and emergency medicine physicians alike.
The AAST Organ Injury Scales (OIS) were established to unify the evaluation and reporting of traumatic injuries across a broad range of anatomical structures. While these scales span 32 different organ-specific injury categories—from solid organs like the spleen and liver to vascular, gastrointestinal, and genitourinary structures—radiology-focused grading systems are most commonly applied to the liver, spleen, and kidneys. These organs are frequently injured in blunt abdominal trauma and are typically assessed via contrast-enhanced CT, making them highly relevant for imaging-based injury stratification.
In this context, the AAST spleen injury calculator helps provide a quantifiable and reproducible framework to categorize splenic trauma. This not only aids in clinical decision-making—such as determining the need for embolization, surgery, or observation—but also facilitates effective communication between emergency departments, radiology teams, and surgical services. As trauma care becomes increasingly protocol-driven and evidence-based, tools like this ensure adherence to nationally recognized guidelines while promoting rapid, standardized triage and treatment planning.
Spleen Injury Grading Calculator
Purpose: To provide a detailed, imaging-guided assessment of spleen injuries in trauma patients using the AAST Spleen Injury Scale.
AAST Spleen Trauma Criteria (2018 Revision)
- Grade I (AIS Severity 2):
- Subcapsular hematoma <10% surface area
- Parenchymal laceration <1 cm depth
- Minor capsular tear
- Grade II (AIS Severity 2):
- Subcapsular hematoma 10–50% surface area
- Intraparenchymal hematoma <5 cm diameter
- Parenchymal laceration 1–3 cm depth
- Grade III (AIS Severity 3):
- Subcapsular hematoma >50% surface area or ruptured
- Intraparenchymal hematoma ≥5 cm or expanding
- Parenchymal laceration >3 cm depth
- Grade IV (AIS Severity 4):
- Laceration involving segmental or hilar vessels
- Resulting in >25% devascularization of the spleen
- Grade V (AIS Severity 5):
- Completely shattered spleen
- Hilar vascular injury with complete devascularization
How to Use the Calculator
- Select the Organ: Choose whether the injury involves the liver, spleen, or kidney.
- Input Imaging Findings: Enter detailed CT findings such as the extent of hematoma, depth of lacerations, and signs of devascularization.
- Calculate the Grade: The calculator processes your input and assigns the appropriate AAST injury grade.
- Apply the Grade Clinically: Use the result to guide trauma management strategies, from conservative observation to interventional radiology or surgery.
Clinical Relevance and Application
In trauma protocols, accurate and early grading of splenic injuries significantly impacts patient outcomes. Low-grade injuries (Grades I–II) are often managed non-operatively, while higher grades (IV–V) may require angiographic embolization or splenectomy. This calculator supports a data-driven, evidence-based workflow by simplifying the classification process and reinforcing consistency in trauma care planning.
Incorporating this tool into clinical practice enhances multidisciplinary collaboration and documentation, while also reducing interobserver variability. Whether used in trauma centers, emergency departments, or surgical wards, it promotes rapid decision-making and aligns with current imaging-based trauma guidelines.
Important Notes
The AAST spleen trauma calculator is not affiliated with or officially endorsed by the American Association for the Surgery of Trauma (AAST). It is intended as a reference and decision-support tool, not a replacement for clinical judgment. Users should always correlate imaging findings with the patient’s clinical status and consult updated AAST guidelines for the most current injury definitions.
You’re wrong, the patient that I’ve demand to calcul the grade have laceration < 3cm and hematoma <5cm so I think grade 2 not 3
Hello Dr. Zoheir,
Thank you for your comment. Per AAST guidelines, if there are multiple injuries, grade should be upgraded to grade III.
Please note this line in the guidelines: “Advance one grade for multiple injuries up to grade III.”
Why does it now state that it’s grade 2 when I choose the same injuries?
Would you please try again and let me know if you still see a grade 2 with these injuries? On my end, the calculator shows a score of 3