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Table 1_

Scaling system for organ specific injuries

Ernest E. Moore, MD, Thomas H. Cogbill, MD, Mark Malangoni, MD, Gregory J. Jurkovich, MD, and Howard R. Champion, MD

 

 

 

Table 1

 

Cervical vascular organ injury scale

 

Grade

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

II 

 

 

 

 

III 

 

 

IV 

 

V

 

Thyroid vein  

Common facial vein 

External jugular vein 

Non-named arterial/venous branches 

External carotid arterial branches (ascending pharyngeal, superior thyroid, Ingual, facial maxillary, occipital, posterior auricular) 

Thyrocervical trunk or primary branches 

Internal jugular vein 

External carotid artery 

Subclavian vein 

Vertebral artery 

Common carotid artery 

Subclavian artery 

Internal carotid artery (extracranial)

 

900.8 

900.8 

900.81 

900.9 

900.8 

 

 

900.8 

900.1 

900.02 

901.3 

900.8 

900.01 

901.1 

900.03

 

 

 

1-3 

 

 

 

 

 

1-3 

2-3 

3-4 

2-4 

3-5 

3-4 

3-5

 

*Increase one grade for multiple grade III or IV injuries involving more than 50% vessel circumference.Decrease one grade for less than 25% vessel circumference disruption for grade IV or V. 

From Moore et al. [1]; with permission.

 

 

 

Table 2

 

Chest wall injury scale*

 

Grade

 

Injury Type

 

Description of Injury

 

 

 

ICD-9

 

AIS-90

 

 

 

 

 

II 

 

 

 

 

III 

 

 

 

IV 

 

 

V

 

Contusion  

Laceration 

Fracture 

 

 

Laceration

Fracture 

 

 

 

Laceration 

Fracture 

 

 

Laceration  

 

Fracture 

Fracture

 

Any size 

Skin & subcutaneous 

< 3 ribs, closed; nondisplaced clavicle closed 

 

 

Skin, subcutaneous and muscle 

>3 adjacent ribs, closed 

Open or displaced clavicle 

Nondisplaced sternum, closed 

Scapular body, open or closed 

Full thickness including pleural penetration 

Open or displaced sternum 

Flail sternum 

Unilateral flail segment (<3 ribs) 

Avulsion of chest wall tissues with underlying rib fractures 

Unilateral flail chest (>3 ribs) 

Bilateral flail chest (>3 ribs on both sides)

 

911.0/922.1 

875.0 

807.01 

807/02 

810.00/810.03 

875.1 

807.03/807.09 

810.10/810.13 

807.2 

811.00/811.18 

862.29 

807.2 

807.3 

807.4 

807.10/807.19 

 

807.4 

807.4

 

1-2 

 

2-3 

 

3-4 

 

3-4 

5

 

*This scale is confined to the chest wall alone and does not reflect associated internal or abdominal injuries.Therefore, further delineation of upper versus lower or anterior versus posterior chest wall was not considered, and a grade VI was warranted.Specifically, thoracic crush was not used as a descriptive term; instead, the geography and extent of fractures and soft tissue injury were used to define the grade.From Moore et al. [2]; with permission.

 


 

 

Table 3

 

Heart injury scale

 

Grade

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

 

II 

 

 

 

 

III 

 

 

 

 

 

 

IV 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VI 

 

 

Blunt cardiac injury with minor ECG abnormality (nonspecific ST or T wave changes, premature arterial or ventricular contraction or persistent sinus tachycardia) 

Blunt or penetrating pericardial wound with out cardiac injury, cardiac tamponade, or cardiac herniation 

Blunt cardiac injury with heart block (right or left bundle branch, left anterior fascicular, or atrioventricular) or ischemic changes (STdepression or T wave inversion) without cardiac failure 

Penetrating tangential myocardial wound up to, but not extending through endocardium, without tamponade 

Blunt cardiac injury with sustained (>6 beats/min) or multilocal ventricular contractions 

Blunt or penetrating cardiac injury with septal rupture, pulmonary or tricuspid valvular incompetence, papillary muscle dysfunction, or distal coronary arterial occlusion without cardiac failure 

Blunt pericardial laceration with cardiac herniation 

Blunt cardiac injury with cardiac failure 

Penetrating tangential myocardial wound up to, but extending through, endocardium, with tamponade 

Blunt or penetrating cardiac injury with septal rupture, pulmonary or tricuspid valvular incompetence, papillary muscle dysfunction, or distal coronary arterial occlusion producing cardiac failure 

Blunt or penetrating cardiac injury with aortic mitral valve incompetence 

Blunt or penetrating cardiac injury of the right ventricle, right atrium, or left atrium 

Blunt or penetrating cardiac injury with proximal coronary arterial occlusion 

Blunt or penetrating left ventricular perforation 

Stellate wound with < 50% tissue loss of the right ventricle, right atrium, or of left atrium 

Blunt avulsion of the heart; penetrating wound producing > 50% tissue loss of a chamber

 

861.01 

 

 

 

 

861.01 

 

 

861.12 

 

861.01 

 

861.01 

 

 

 

 

861.01 

861.12 

 

861.12 

 

 

 

 

 

861.03 

 

861.03 

 

861.13 

861.03 

 

861.13 

 

 

 

 

 

 

 

 

 

3-4 

 

3-4 

 

 

 

 

3-4 

 

 

 

 

 

 

 

 

 

 

6

 

*Advance one grade for multiple wounds to a single chamber or multiple chamber involvement. 

From Moore et al. [3]; with permission.

 


 

 

Table 4

 

Lung Injury Scale

 

Grade*

 

Injury Type

 

Description of Injury

 

ICD-9

 

AIS-90

 

 

II 

 

 

III 

 

 

 

 

 

IV 

 

 

 

 

 

VI

 

Contusion 

 

Contusion 

 

Laceration 

Contusion 

 

Laceration 

 

 

Hematoma 

Laceration 

 

Hematoma 

Vascular  

 

Vascular 

 

Vascular

 

Unilateral, <1 lobe 

 

Unilateral, single lobe 

 

Simple pneumothorax 

Unilateral, > 1 lobe 

 

Persistent (> 72 hrs) air leak from distal airway 

 

 

Nonexpanding intraparenchymal 

Major (segmental or lobar) air leak 

 

Expanding intraparenchymal 

Primary branch intrapulmonary vessel disruption 

Hilar vessel disruption 

 

Total uncontained transection of pulmonary hilum

 

861.12 

861.31 

861.20 

861.30 

860.0/1 

861.20 

861.30 

860.0/1 

860.4/5 

862.0 

861.30 

862.21 

861.31 

 

901.40 

 

901.41 

901.42 

901.41 

901.42 

 

 

 

 

 

3-4 

 

 

 

4-5 

 

 

3-5 

 

 

 

 

*Advance one grade for bilateral injuries up to grade III.Hemothorax is scored under thoracic vascular injury scale. 

From Moore et al. [3]; with permission.

 

 

 

 

 

Table 5

 

 

Thoracic Vascular Injury Scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

 

 

 

II 

 

 

 

III 

 

 

IV 

 

 

 

 

 

 

VI 

 

 

Intercostal artery/vein 

Internal mammary artery/vein 

Bronchial artery/vein 

Esophageal artery/vein 

Hemizygous vein 

Unnamed artery/vein 

Azygos vein 

Internal jugular vein 

Subclavian vein 

Innominate vein 

Carotid artery 

Innominate artery 

Subclavian artery 

Thoracic aorta, descending 

Inferior vena cava (intrathoracic) 

Pulmonary artery, primary intraparenchymal branch 

Pulmonary vein, primary intraparenchymal branch 

Thoracic aorta, ascending and arch 

Superior vena cava 

Pulmonary artery, main trunk 

Pulmonary vein, main trunk 

Uncontained total transection of thoracic aorta or pulmonary hilum

 

901.81 

901.82 

901.89 

901.9 

901.89 

901.9 

901.89 

900.1 

901.3 

901.3 

900.01 

901.1 

901.1 

901.0 

902.10 

901.41 

901.42 

901.0 

901.2 

901.41 

901.42 

901.0 

901.41 

901.42

 

2-3 

2-3 

2-3 

2-3 

2-3 

2-3 

2-3 

2-3 

3-4 

3-4 

3-5 

3-4 

3-4 

4-5 

3-4 

3-4 

 

 

 

*Increase one grade for multiple grade III or IV injuries if more than 50% circumference; decrease one grade for grade IV injuries if less than 25% circumference. 

From Moore et al [3]; with permission

 

 


 

 

Table 6

 

 

Diaphragm injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

II 

III 

IV 

V

 

Contusion 

Laceration <2cm 

Laceration 2-10cm 

Laceration >10 cm with tissue loss < 25 cm2 

Laceration with tissue loss > 25 cm2

 

862.0 

862.1 

862.1 

862.1 

862.1

 

3

 

 

*Advance one grade for bilateral injuries up to grade III. 

From Moore et al. [3]; with permission

 

 

 

 

Table 7

 

 

Spleen injury scale (1994 revision)

 

Grade*

 

Injury type

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

II 

 

 

 

 

 

III 

 

 

 

 

 

 

 

IV 

 

 

V

 

Hematoma 

 

Laceration 

Hematoma 

 

 

Laceration 

 

 

Hematoma 

 

 

 

 

Laceration 

 

 

Laceration 

 

 

Laceration 

Vascular

 

Subcapsular, <10% surface area 

 

Capsular tear, <1cm parenchymal depth 

Subcapsular, 10%-50% surface area; intraparenchymal, <5 cm in diameter 

 

Capsular tear, 1-3cm parenchymal depth that does not involve a trabecular vessel 

 

Subcapsular, >50% surface area or expanding; ruptured subcapsular or parecymal hematoma; intraparenchymal hematoma > 5 cm or expanding 

 

>3 cm parenchymal depth or involving trabecular vessels 

 

Laceration involving segmental or hilar vessels producing major devascularization (>25% of spleen) 

Completely shattered spleen 

Hilar vascular injury with devascularizes spleen

 

865-01 

865.11 

865.02 

865.01 

 

865.11 

865.02 

 

865.12 

 

 

 

 

865.03 

865.03 

 

865.13 

 

 

 

865.04 

865.04

 

 

 

 

 

 

 

 

 

 

 

 

 

5

 

 

*Advance one grade for multiple injuries up to grade III. 

From Moore et al. [4]; with permission

 

 


 

 

Table 8

 

Liver injury scale (1994 revision)

 

Grade*

 

Type of Injury

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

II 

 

 

 

 

 

III 

 

 

 

 

 

IV 

 

 

V

 

Hematoma 

 

Laceration 

 

Hematoma 

 

 

Laceration 

 

 

Hematoma 

 

 

 

Laceration 

 

Laceration 

 

 

Laceration 

 

 

Vascular 

 

Vascular

 

Subcapsular, <10% surface area 

 

Capsular tear, <1cm parenchymal depth 

 

Subcapsular, 10% to 50% surface area: intraparenchymal <10 cm in diameter 

 

Capsular tear 1-3 parenchymal depth, <10 cm in length 

 

Subcapsular, >50% surface area of ruptured subcapsular or parenchymal hematoma; intraparenchymal hematoma > 10 cm or expanding 

3 cm parenchymal depth 

 

Parenchymal disruption involving 25% to 75% hepatic lobe or 1-3 couinaudís segments 

 

Parenchymal disruption involving >75% of hepatic lobe or >3 Couinaudís segments within a single lobe 

Juxtahepatic venous injuries; ie, retrohepatic vena cava/central major hepatic veins 

Hepatio avulsion

 

864.01 

864.11 

864.02 

864.12 

864.01 

 

864.11 

864.03 

 

864.03 

 

 

 

 

864.04 

864.14 

864.04 

 

864.14 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5

 

*Advance one grade for multiple injuries up to grade III 

From Moore et al. [4]; with permission

 

 

 

Table 9

 

 

Extrahepatic billiary tree injury scale

 

Grade*

 

Desription of injury

 

ICD-9

 

AIS-90

 

 

 

II 

 

III 

 

IV 

 

 

 

 

 

 

Gallbladder contusion/hematoma 

Portal triad contusion 

Partial gallbladder avulsion from liver bed; cystic duct intact 

Laceration or perforation of the gallbladder 

Complete gallbladder avulsion from liver bed 

Cystic duct laceration 

Partial or complete right hepatic duct laceration 

Partial or complete left hepatic duct laceration 

Partial common hepatic duct laceration (<50%) 

Partial common bile duct laceration (<50%) 

>50% transection of common hepatic duct 

>50% transection of common bile duct 

Combined righ and left hepatic duct injuries 

Intraduodenal or intrapancreatic bile duct injuries

 

868.02 

868.02 

868.02 

868.12 

868.02 

868.12 

868.12 

868.12 

868.12 

868.12 

868.12 

868.12 

868.12 

868.12

 

3-4 

3-4 

3-4 

3-4

 

 

*Advance one grade for multiple injuries up to grade III. 

From Moore et al. [5]; with permission

 

 


 

 

Table 10

 

 

Pancreas Injury Scale

 

Grade*

 

Type of Injury

 

Description of Injury

 

ICD-9

 

AIS-90

 

 

 

 

II 

 

 

 

III 

 

IV 

 

V

 

Hematoma 

 

Laceration 

Hematoma 

 

Laceration 

 

Laceration 

 

Laceration

 

Minor contusion without duct injury 

 

Superficial laceration without duct injury 

Major contusion without duct injury or tissue loss 

Major laceration without duct injury or tissue loss 

Distal transection or parenchymal injury with duct injury 

Proximal transection or parenchymal injury involving ampulla 

Massive disruption of pancreatic head

 

863.81-863.84 

 

 

863.81-863.84 

 

 

 

863.92/863.94 

 

863.91 

 

863.91

 

 

 

 

 

5

 

 

*Advance one grade for multiple injuries up to grade III. *863.51,863.91 - head; 863.99,862.92-body;863.83,863.93-tail. *Proximal pancreas is to the patientsí right of the superior mesenteric vein. 

From Moore et al. [6]: with permission.

 

 

 

 

Table 11

 

 

Esophagus injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

II 

III 

IV 

V

 

Contusion/hematoma 

Partial thickness laceration 

Laceration <50% circumference 

Laceration >50% circumference 

Segmental loss or devascularization <2cm 

Segmental loss or devascularization >2cm

 

862.22/.32 

862.22/.32 

862.22/.32 

862.22/.32 

862.22/.32 

862.22/.32

 

5

 

 

*Advance one grade for multiple lesions up to grade III. 

From Moore et al [5]; with permission

 

 

 

 

Table 12

 

 

Stomach injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

II 

 

 

III 

 

 

IV 

V

 

Contusion/hematoma 

Partial thickness laceration 

Laceration <2cm in GE junction or pylorus 

<5cm in proximal 1/3 stomach 

<10cm in distal 2/3 stomach 

Laceration >2cm in GE junction or pylorus 

>5cm in proximal 1/3 stomach 

>10cm in distal 2/3 stomach 

Tissue loss or devascularization <2/3 stomach 

Tissue loss or devascularization >2/3 stomach

 

863.0/.1 

863.0/.1 

863.0/.1 

863.0/.1 

863.0/.1 

863.0/.1 

863.0/.1 

863.0/.1 

863.0/.1 

863.0/.1

 

4

 

 

*Advance one grade for multiple lesions up to grade III.GE-gastroesophageal. 

From Moore et al.[5]; with permission

 

 


 

 

Table 13

 

 

Duodenum injury scale

 

Grade*

 

Type of injury

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

II 

 

III 

 

 

IV 

 

V

 

Hematoma 

Laceration 

Hematoma 

Laceration 

Laceration 

 

 

Laceration 

 

Laceration 

Vascular

 

Involving single portion of duodenum 

Partial thickness, no perforation 

Involving more than one portion 

Disruption <50% of circumference 

Disruption 50%-75% of circumference of D2 

Disruption 50%-100% of circumference of D1,D3,D4 

Disruption >75% of circumference of D2 

Involving ampulla or distal common bile duct 

Massive disruption of dijodenopancreatic complex 

Devascularization of duodenum

 

863.21 

863.21 

863.21 

863.31 

863.31 

863.31 

 

863.31 

 

863.31 

 

863.31

 

 

 

5

 

 

*Advance one grade for multiple injuries up to grade III.D1-first position of duodenum; D2-second portion of duodenum; D3-third portion of duodenum; D4-fourth portion of duodenum 

From Moore et al. [6]; with permission.

 

 

 

 

Table 14

 

 

Small bowel injury scale

 

Grade*

 

Type of injury

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

II 

III 

 

IV 

V

 

Hematoma 

 

Laceration 

Laceration 

Laceration 

 

Laceration 

Laceration 

 

Vascular

 

Contusion or hematoma without devascularization 

Partial thickness, no perforation 

Laceration <50% of circumference 

Laceration > 50% of circumference without transection 

Transection of the small bowel 

Transection of the small bowel with segmental tissue loss 

Devascularized segment

 

863.20 

 

863.20 

863.30 

863.30 

 

863.30 

863.30 

 

863.30

 

 

 

 

4

 

 

*Advance one grade for multiple injuries up to grade III. 

From Moore et al. [6]; with permission

 

 

 

 

Table 15

 

 

Colon injury scale

 

Grade*

 

Type of injury

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

II 

III 

 

IV 

V

 

Hematoma 

 

Laceration 

Laceration 

Laceration 

 

Laceration 

Laceration

 

Contusion or hematoma without devascularization 

Partial thickness, no perforation 

Laceration <50% of circumference 

Laceration > 50% of circumference without transection 

Transection of the colon 

Transection of the colon with segmental tissue loss

 

863.40-863.44 

 

863.40-863.44 

863.50-863.54 

863.50-863.54 

 

863.50-863.54 

863.50-863.54

 

 

 

4

 

 

*Advance one grade for multiple injuries up to grade III. *863.41,863.51-ascending;863.42, 863.52-traverse;863.45,863.53-descending; 863.44,863.54-rectum. 

From Moore et al. [6]; with permission

 

 


 

 

Table 16

 

 

Rectum injury scale

 

Grade*

 

Type of injury

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

II 

III 

IV 

 

V

 

Hematoma 

 

Laceration 

Laceration 

Laceration 

Laceration 

 

Vascular

 

Contusion or hematoma without devascularization 

Partial-thickness laceration 

Laceration < 50% of circumference 

Laceration > 50% of circumference 

Full-thickness laceration with extension into the perineum 

Devascularized segment

 

863.45 

 

863.45 

863.55 

863.55 

863.55 

 

863.55

 

 

 

5

 

 

*Advance one grade for multiple injuries up to grade III. 

From Moore et al. [6]; with permission

 

 

 

 

Table 17

 

 

Abdominal vascular injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

 

 

 

 

 

 

 

II 

 

 

 

 

 

 

 

III 

 

 

 

 

IV 

 

 

 

V

 

Non-named superior mesenteric artery or superior mesenteric vein branches 

Non-named inferior mesenteric artery or inferior mesenteric vein branches 

Phrenic artery or vein 

Lumbar artery or vein 

Gonadal artery or vein 

Ovarian artery or vein 

Other non-named small arterial or venous structures requiring ligation 

Right, left, or common hepatic artery 

Splenic artery or vein 

Right or left gastric arteries 

Gastroduodenal artery 

Inferior mesenteric artery, or inferior mesenteric vein, trunk 

Primary named branches of messenteric artery (eg, ileocolic artery) or messenteric vein 

Other names abdominal vessels requiring ligation or repair 

Superior mesenteric vein, trunk 

Renal artery or vein 

Illiac artery or vein 

Hypogastric artery or vein 

Vena cava, infrarenal 

Superior mesenteric artery, trunk 

Celiac axis proper 

Vena cava, suprarenal and infrahepatic 

Aorta, infrarenal 

Portal vein 

Extraparenchymal hepatic vein 

Vena cava, retrohepatic or suprahepatic 

Aorta suprarenal, subdiaphragmatic

 

902.20/.39 

 

902.27/.32 

 

902.69 

902.89 

902.69 

902.81/.82 

902.80 

 

902.22 

902.23/.34 

902.21 

902.24 

902.27/.32 

902.26/.31 

 

902.69 

902.31 

902.41/.42 

902.53/.54 

902.51/.52 

902.10 

902.25 

902.24 

902.10 

902.00 

902.33 

902.11 

902.19 

902.00

 

NS 

 

NS 

 

NS 

NS 

NS 

NS 

NS 

 

 

3/5 

4

 

 

*This classification system is applicable to extraparenchymal vascular injuries.If the vessel injury is within 2 cm of the organ parenchyma, refer to specific organ injury scale.Increase one grade for multiple grade III or IV injuries involving > 50% vessel circumference.Downgrade one grade if <25% vessel circumference laceration for grades IV or V. NS-not scored. 

From Moore et al [2]; with permission

 

 


 

 

Table 18

 

 

Adrenal organ injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

II 

III 

IV 

V

 

Contusion 

Laceration involving only cortex (<2 cm) 

Laceration extending into medulla (> 2 cm) 

>50% parenchymal destruction 

Total parenchymal destruction (including massive intraparenchymal hemorrhage) 

Avulsion from blood supply

 

868.01/.11 

868.01/.11 

868.01/.11 

868.01/.11 

868.01/.11 

 

 

 

3

 

 

*Advance one grade for bilateral lesions up to grade V 

From Moore et al [1]; with permission

 

 

 

 

Table 19

 

 

Kidney injury scale

 

Grade*

 

Type of injury

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

 

 

II 

 

 

 

 

 

III 

 

 

 

IV 

 

 

 

V

 

Contusion 

 

Hematoma 

 

 

Hematoma 

 

 

Laceration 

 

 

Laceration 

 

 

 

Laceration 

 

Vascular 

 

Laceration 

Vascular

 

Microscopic or gross hematuria, urologic studies normal 

Subcapsular, nonexpanding without parenchymal laceration 

 

Nonexpanding perirenal hematoma confirmed to renal retroperitoneum 

 

<1.0 cm parenchymal depth of renal cortex without urinary extravagation 

 

<1.0 cm parenchymal depth of renal cortex without collecting system rupture or urinary extravagation 

 

Parenchymal laceration exteding through renal cortex, medulla, and collecting system 

Main renal artery or vein injury wtih contained hemorrhage 

Completely shattered kideny 

Avulsion of renal hilum which devascularizes kidney

 

 

 

866.01 

 

866.11 

866.01 

 

866.11 

866.02 

 

866.12 

866.02 

 

 

866.12 

 

 

 

 

866.03 

866.13

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*Advance one grade for bilateral injuries up to grade III 

From Moore et al. [7]; with permission

 

 


 

 

Table 20

 

 

Ureter injury scale

 

Grade*

 

Type of injury

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

II 

 

III 

 

IV 

 

 

V

 

Hematoma 

 

 

Laceration 

 

Laceration 

 

Laceration 

 

 

Laceration

 

Contusion or hematoma without devascularization 

 

< 50% transecection 

 

> 50% transection 

 

Complete transection with < 2cm devascularization 

 

Avuslion with > 2cm of devascularization

 

867.2 

 

867.3 

867.2 

867.3 

867.2 

867.3 

867.2 

 

867.3 

867.2 

867.3

 

 

 

 

 

 

 

3

 

 

*Advance one grade for bilateral up to grade III. 

From Moore et al. [2]; with permission

 

 

 

 

Table 21

 

 

Bladder injury scale

 

Grade*

 

Injury type

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

 

II 

 

III 

 

IV 

 

 

 

 

Hematoma 

 

Laceration  

 

Laceration 

 

Laceration 

 

Laceration 

 

Laceration

 

Contusion, intramural hematoma 

 

Partial thickness 

 

Extraperitoneal bladder wall laceration <2 cm 

 

Extraperitoneal (>2cm) or intraperitoneal (<2cm) bladder wall laceration 

Intraperitoneal bladder wall laceration >2cm 

 

Intraperitoneal or extraperitoneal bladder wall laceration extending into the bladder neck or ureteral oifice (trigone)

 

867.0 

867.1 

867.0 

867.1 

867.0 

867.1 

867.0 

867.1 

867.0 

867.1 

867.0 

867.1

 

 

 

 

 

 

 

 

 

 

*Advance one grade for multiple lesions up to grade III 

From Moore et al. [2]; with permission

 

 


 

 

Table 22

 

 

Urethra injury scale

 

Grade*

 

Injury type

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

II 

 

 

III 

 

 

IV

 

Contusion 

 

Stretch injury 

 

 

Partial disruption 

 

 

Complete disruption 

 

 

 

Complete disruption

 

Blood at urethral meatus; retrography normal 

 

Elongation of urethra without extravasation on urethrography 

 

Extravastion of urethrography contrast at injury site with visualization in the bladder 

 

Extravasation of urethrography contrast at injury site without visualization in the bladder; <2cm of urethra seperation 

 

 

Complete transaction with >2 cm urethral separation, or extension into the prostate or vagina

 

867.0 

867.1 

867.0 

 

867.1 

867.0 

 

867.1 

867.0 

 

 

867.1 

 

867.0 

 

 

867.1

 

 

 

 

 

 

 

 

 

 

4

 

 

*Advance one grade for bilateral injuries up to grade III 

From Moore et al. [2]; with permission

 

 

 

 

Table 23

 

 

Uterus (nonpregnant) injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

II 

III 

IV 

V

 

Contusion/hematoma 

Superficial laceration (<1 cm) 

Deep laceration (> 1 cm) 

Laceration involving uterine artery 

Avulsion/devascularization

 

867.4/.5 

867.4/.5 

867.4/.5 

902.55 

867.4/.5

 

3

 

 

*Advance one grade for multiple injuries up to grade III 

From Moore et al. [5]; with permission

 

 

 

 

Table 24

 

 

Uterus (pregnant) injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

II 

 

III 

 

 

IV 

 

V

 

Contusion or hematoma (without placental abruption) 

Superficial laceration (<1cm) or partial placental abruption <25% 

Deep laceration (>1cm) occurring in second trimester or placental abruption >25% but <50% 

Deep laceration (>1cm) in third trimester 

Laceration involving uterine artery 

Deep laceration (>1cm) with >50% placental abruption 

Uterine rupture 

††† Second trimester 

††† Third trimester 

Complete placental abruption

 

867.4/.5 

867.4/.5 

 

867.4/.5 

 

867.4/.5 

902.55 

867.4/.5 

 

867.4/.5 

867.4/.5 

867.4/.5

 

 

 

 

4-5

 

 

*Advance one grade for multiple injuries up to grade III 

From Moore et al. [5]; with permission

 

 


 

 

Table 25

 

 

Fallopian tube injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

II 

III 

IV 

V

 

Hematoma or contusion 

Laceration <50% circumference 

Laceration >50% circumference 

Transection 

Vascular injury; devascularized segment

 

867.6/.7 

867.6/.7 

867.6/.7 

867.6/.7 

902.89

 

2

 

 

*Advance one grade for bilateral injuries up to grade III 

From Moore et al. [5]; with permission

 

 

 

 

Table 26

 

 

Ovary injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

II 

III 

IV 

V

 

Contusion or hematoma 

Superficial laceration (depth <0.5 cm) 

Deep laceration (depth > 0.5 cm) 

Partial disruption or blood supply 

Avulsion or complete parenchymal destruction

 

867.6/.7 

867.6/.7 

867.8/.7 

902.81 

902.81

 

3

 

 

*Advance one grade for bilateral injuries up to grade III 

From Moore et al. [5]; with permission

 

 

 

 

Table 27

 

 

Vagina injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

II 

III 

IV 

V

 

Contusion or hematoma 

Laceration, superficial (mucosa only) 

Laceration, deep into fat or muscle 

Laceration, complex, into cervix or peritoneum 

Injury into adjacent organs (anus, rectum, urethra, bladder)

 

922.4 

878.6 

878.6 

868.7 

878.7

 

3

 

 

*Advance one grade for multiple injuries up to grade III 

From Moore et al. [5]; with permission

 

 

 

 

Table 28

 

 

Vulva injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

II 

III 

IV 

V

 

Contusion or hematoma 

Laceration, superficial (skin only) 

Laceration, deep (into fat or muscle) 

Avulsion; skin, fat or muscle 

Injury into adjacent organs (anus, rectum, urethra, bladder)

 

922.4 

878.4 

878.4 

878.5 

878.5

 

3

 

 

*Advance one grade for multiple injuries up to grade III 

From Moore et al. [5]; with permission

 

 


 

 

Table 29

 

 

Testis injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

II 

III 

IV 

 

V

 

Contusion/hematoma 

Subclinical laceration of tunica albuginea 

Laceration of tunica albuginea with <50% parenchymal loss 

Major laceration of tunica albuginea with >50% parenchymal loss 

Total testicular destruction or avulsion

 

911.0-922.4 

922.4 

878.2 

878.3 

 

878.3 

 

 

 

2

 

 

*Advance one grade for bilateral lesions up to grade V 

From Moore et al [1]; with permission

 

 

 

 

Table 30

 

 

Scrotum injury scale

 

Grade

 

Description of injury

 

ICD-9

 

AIS-90

 

 

II 

III 

IV 

V

 

Contusion 

Laceration <25% of scortal diameter 

Laceration >25% of scrotal diameter 

Avulsion <50% 

Avulsion >50%

 

922.4 

878.2 

878.3 

878.3 

878.3

 

2

 

 

From Moore et al [1]; with permission

 

 

 

 

Table 31

 

Penis injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

II 

III 

 

 

IV 

 

V

 

Cutaneous laceration/contusion 

Buckís fascia (cavernosum) laceration without tissue loss 

Cutaneous avulsion 

Laceration through glans/meatus 

Cavemosal or urethral defect <2cm 

Partial penectomy 

Cavarnosal or urethral defect > 2 cm 

Total penectomy

 

911.0-922.4 

878.0 

878.1 

 

 

878.1 

 

876.1

 

 

 

 

3

 

*Advance one grade for multiple injuries up to grade III 

From Moore et al. [1]; with permission

 


 

 

Table 32

 

 

Peripheral vascular organ injury scale

 

Grade*

 

Description of injury

 

ICD-9

 

AIS-90

 

 

 

 

 

 

 

II 

 

 

 

III 

 

 

 

 

 

 

 

IV 

 

V

 

Digital artery/vein 

Palmar artery/vein 

Deep palmar artery/vein 

Dorsalla pedia artery 

Plantar artery/vein 

Non-named arterial/venous branches 

Basilic/cephalic vein 

Saphenous vein 

Radial artery 

Ulnar artery 

Axillary vein 

Superficial/deep femoral vein 

Popliteal vein 

Brachial artery 

Anterior tibial artery 

Posterior tibial artery 

Peroneal artery 

Tibioperoneal trunk 

Superficial/deep femoral artery 

Popliteal artery 

Axillary artery 

Common femoral artery

 

903.5 

903.4 

904.6 

904.7 

904.5 

903.8/904.7 

903.8 

904.3 

903.2 

903.3 

903.02 

903.02 

904.42 

903.1 

904.51/904.52 

904.53/904.54 

904.7 

904.7 

904.1/904.7 

904.41 

903.01 

904.0

 

1-3 

1-3 

1-3 

1-3 

1-3 

1-3 

1-3 

1-3 

1-3 

1-3 

2-3 

2-3 

2-3 

2-3 

1-3 

1-3 

1-3 

2-3 

3-4 

2-3 

2-3 

3-4

 

 

*Increase one grade for multiple grade III or IV injuries involving >50% vessel circumference.Decrease one grade for < 25% vessel circumference disruption for grades IV or V 

From Moore et al [1]; with permission