Organ Injury Scaling VII

Abstract

The Organ Injury Scaling (OIS) Committee of the American Association for the Surgery of Trauma (AAST) was organized formally in 1987; the fundamental change was to devise injury severity scores for individual organs to facilitate clinical investigation and outcomes research. The OIS Committee members were selected on the basis of recognized clinical expertise as well as experience with injury scoring. The Committee was specifically asked to develop a comprehensive system of injury scales. OIS VII represents the final step in fulfilling the mission, leaving neurosurgical and orthopedic injuries to our learned colleagues in these allied disciplines. In fact, the ad hoc OIS Committee of the AAST has now been superseded by the standing Injury Assessment and Outcomes (IAO) Committee, established at the October 1995 Annual Meeting. OIS VII is comprised of cervical vascular (Table 1), peripheral vascular (Table 2), adrenal (Table 3), penis (Table 4), testis (Table 5), and scrotum (Table 6) injury scales. OISs I through VI, addressing the remaining torso areas, are detailed in previous issues of the Journal. [1-6] Conceptually, OIS is a classification scheme based on the anatomic disruption of an individual organ scaled 1 to 6, from the least to most severe injury. Grades 1 to 5 represent increasingly complex injuries encountered in salvageable patients, whereas grade 6 is a destructive lesion incompatible with survival. Severity is based on potential threat to the patient's life, and the progressive scale is derived from a comprehensive review of the current literature with consensus of the OIS Committee; the AAST Board of Managers renders final approval before submission for publication. Despite this extensive preparation process, OISs are inherently limited by design and, thus, are anticipated to ultimately necessitate revision. Refinement should be predicated on clinical experience and appropriate scientific analysis. Indeed, the first OISs (spleen and liver) have undergone formal restructuring. [5] The new IOA Committee of the ASST looks forward to your critical evaluation of the enclosed OISs and assistance in improving them in the future.Table 1: Cervical vascular organ injury scale.Table 2: Peripheral vascular organ injury scale.Table 3: Adrenal organ injury scale.Table 4: Penis injury scale.Table 5: Testis injury scale.Table 6: Scrotum injury scale.