Which scoring system specifically determines the need for operative intervention in splenic trauma based on CT grading of the injury and haemodynamic status, widely used in AAST guidelines?

• A Injury Severity Score (ISS)
• B Revised Trauma Score (RTS)
• C AAST Organ Injury Scale (OIS) for spleen ✓
• D Abbreviated Injury Scale (AIS)

Explanation

The AAST Organ Injury Scale (OIS) for splenic trauma grades injury from I (subcapsular haematoma < 10%) to V (completely shattered spleen or hilar vascular injury) based on CT findings. It guides management: Grade I–III with haemodynamic stability → non-operative management (NOM); Grade IV–V or haemodynamic instability → angioembolisation or splenectomy. ISS and RTS assess overall trauma severity but do not direct organ-specific intervention.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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