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AAST Organ Injury Grading Under development

Pick the organ and the most severe imaging finding; the tool assigns the AAST Organ Injury Scale grade and writes a report line. Spleen and liver use the 2018 revision (CT vascular injury incorporated); kidney the 2025 revision; pancreas the 2024 revision; hollow viscus and GU use the classic scales.

Global rules. The highest criterion determines the grade. For spleen and liver (2018), multiple grade I–II injuries in one organ advance to grade III, and a CT vascular injury (pseudoaneurysm, AV fistula, or active extravasation) is incorporated into the grade. The 2025 kidney scale drops multi-injury and bilateral advancement: each kidney is graded on its own worst injury, and active bleeding is what moves it to grade IV or V. Bilateral ureteral injuries still advance one grade, up to III. Imaging grade is one of three inputs (imaging, operative, pathologic) — the operative or pathologic grade can be higher.

Most severe finding

Injury type — names the finding in the report

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AAST grade

Grade tables & notes

Abdominal vascular (1992 OIS)

Graded by the specific named vessel injured rather than by a single I–V solid-organ scale, so it is provided as reference rather than a computed grade here. Report the vessel, the injury (intimal/partial/complete transection, active extravasation), and hemodynamic status.

Sources

Kozar RA, et al. Organ injury scaling 2018 update: spleen, liver, and kidney. J Trauma Acute Care Surg 2018 (spleen and liver). · Keihani S, et al. Kidney organ injury scaling: 2025 update. J Trauma Acute Care Surg 2025;98:448–451. · Matta R, et al. Proposed revision of the AAST renal organ injury scale (MiGUTS). J Trauma Acute Care Surg 2024;97:205–212. · AAST pancreatic organ injury scale: 2024 revision. J Trauma Acute Care Surg 2024. · Moore EE, et al. Organ injury scaling (ureter, bladder, urethra, abdominal vascular). J Trauma 1992. · Coccolini F, et al. WSES-AAST duodeno-pancreatic and extrahepatic biliary tree trauma. World J Emerg Surg. · Visual guide: Dreizin D, et al. Grading abdominal trauma: the revised 2018 AAST-OIS for spleen, liver, and kidney. RadioGraphics 2023 (its kidney section predates the 2025 update). Content paraphrased and summarized; verify against the AAST tables for edge cases.