AAST liver injury scale 2018


Grade I           
— Subcapsular hematoma <10% surface area
— Parenchymal laceration <1 cm in depth

Grade II

— Subcapsular hematoma 10–50% surface area
— Intraparenchymal hematoma <10 cm in diameter
— Laceration 1–3 cmin depth and ≤ 10 cm length
Grade III

— Subcapsular hematoma >50% surface area; ruptured subcapsular or parenchymal hematoma
— Intraparenchymal hematoma >10 cm
— Laceration >3 cm depth
— Any injury in the presence of a liver vascular injury or active bleeding contained within liver parenchyma

Grade IV

— Parenchymal disruption involving 25–75% of a hepatic lobe
— Active bleeding extending beyond the liver parenchyma into the peritoneum

Grade V

— Parenchymal disruption >75% of hepatic lobe
— Juxtahepatic venous injury to include retrohepatic vena cava and central major hepatic veins



Note: Advance one grade for multiple hepatic injuries up to grade III.

Link to original article: Trauma Acute Care Surg; 85(6):1119- 1122