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 |
I 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 |
I 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 1 1-2 2 1 2-3 2 2 2 2 2 3-4 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 |
I II III IV V 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 (ST depression 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 3 3 3-4 3-4 3-4 3 3 5 5 5 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 |
I II III IV V 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 3 3 3 3-4 4-5 3-5 4 4 |
*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 |
|
I II III IV V 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 3 5 3-4 4 4 5 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 |
|
I 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 |
2 3 3 3 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 |
|
I 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 |
2 2 2 2 3 3 4 4 5 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 |
I 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 couinaud’s segments Parenchymal
disruption involving >75% of hepatic lobe or >3 Couinaud’s 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 |
2 2 2 3 3 4 5 5 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 |
|
I II III IV V |
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 |
2 2 2 2 3 3 3 3 3 3 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 |
|
I 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 |
2 2 2 3 3 3 4 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 patients’
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 |
|
I 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 |
2 3 4 4 5 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 |
|
I 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 |
2 2 3 3 3 3 3 3 4 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 |
|
I 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 |
2 3 2 4 4 4 5 5 5 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 |
|
I 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 |
2 2 3 3 4 4 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 |
|
I 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 |
2 2 3 3 4 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 |
|
I 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 |
2 2 3 4 5 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 |
|
I 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 3 3 3 3 3 3 3 3 3 3 3 3 3 3 4 3 3/5 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 |
|
I 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 |
1 1 2 2 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 |
|
I 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 |
2 2 2 2 3 4 4 5 5 |
|
*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 |
|
I 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 |
2 2 3 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 |
|
I II III IV V |
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 |
2 3 4 4 4 4 |
|
*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 |
|
I 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 |
2 2 2 3 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 |
|
I 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 |
2 2 3 3 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 |
|
I 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 |
2 3 3 4 4 4 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 |
|
I 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 2 2 2 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 |
|
I 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 |
1 2 3 3 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 |
|
I 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 |
1 1 2 3 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 |
|
I 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 |
1 1 2 3 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 |
|
I 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 |
1 1 2 2 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 |
|
I 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 |
1 1 2 2 2 |
|
From Moore et al
[1]; with permission |
|
Table 31 |
|||
Penis injury scale |
|||
Grade* |
Description of
injury |
ICD-9 |
AIS-90 |
I II III IV V |
Cutaneous
laceration/contusion Buck’s 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 |
1 1 3 3 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 |
|
I 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 |
|