AAST Liver Injury Scale
AAST-OIS 2018 revision (Kozar et al.)Grades hepatic trauma on CT with the 2018 revision of the AAST organ injury scale, including vascular-injury and active-bleeding criteria.
Also searched as: trauma · hepatic · injury grading · CT · hepatic injury · grading
Lower concern
No injury findings selected
- None of the listed findings is present — on this assessment the organ shows no traumatic injury pattern, so no AAST grade applies (grade I is the mildest injury).
- If any listed finding is present, select it; the single highest-grade criterion determines the AAST grade.
How this tool works
The AAST liver injury scale stratifies hepatic trauma from grade I (small subcapsular hematoma or superficial capsular tear) to grade V (disruption of more than 75% of a lobe or juxtahepatic venous injury). The 2018 revision incorporated vascular findings: a hepatic pseudoaneurysm or arteriovenous fistula, or active bleeding contained within the parenchyma, makes the injury at least grade III, while bleeding that reaches the peritoneum is grade IV; the revision also dropped Couinaud segment counts in favor of percent-of-lobe disruption. The highest applicable finding sets the grade, and multiple separate injuries advance the grade by one, up to grade III.
References
- Kozar RA, et al. Organ injury scaling 2018 update: Spleen, liver, and kidney. J Trauma Acute Care Surg. 2018;85(6):1119-1122
- AAST liver injury scale, 2018 revision (Table 1)
- Radiopaedia: AAST liver injury scale
- RadioGraphics: Grading abdominal trauma - 2018 AAST-OIS changes for spleen, liver, kidney
Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.
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