AAST spleen injury scale 2018


Grade I                   
— Subcapsular hematoma <10% of surface area
— Parenchymal laceration <1 cm depth
— Capsular tear
Grade II

— Subcapsular hematoma 10-50% of surface area
— Intraparenchymal hematoma <5 cm
— Parenchymal laceration 1-3 cm in depth
Grade III

— Subcapsular hematoma >50% of surface area
— Ruptured subcapsular or intraparenchymal hematoma ≥5 cm
— Parenchymal laceration >3 cm in depth
Grade IV
— Any injury in the presence of a splenic vascular injury or active bleeding confined within splenic capsule
— Parenchymal laceration involving segmental or hilar vessels producing >25% devascularisation
Grade V

— Shattered spleen
— Any injury in the presence of splenic vascular injury* with active bleeding extending beyond the spleen into the peritoneum



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

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