AASTBladder Injury Scale
Highest Finding (Imaging/OR)
Bladder Injury Grading
Select the highest radiologic or operative finding to determine the AAST severity grade.
Guidelines & Evidence
Verified
Last Review: 2026
When to Use
The AAST Bladder Injury Scale is indicated in patients with suspected bladder trauma, most commonly following blunt mechanisms such as motor vehicle collisions with pelvic fractures or direct lower abdominal impact when the bladder is distended. It is also applicable in penetrating trauma to the pelvis or lower abdomen. Use is recommended in hemodynamically stable patients undergoing CT cystography or during operative exploration. The scale helps differentiate contusions/partial tears amenable to catheter drainage from full-thickness intraperitoneal or complex extraperitoneal ruptures requiring operative repair.
The scale does NOT replace clinical judgment in hemodynamically unstable patients; prioritize damage control resuscitation and laparotomy over detailed grading. It has limited utility in isolated pediatric or iatrogenic injuries without validation in those cohorts.
| Tool | Primary Use | Strength | Limitation |
|---|---|---|---|
| AAST Bladder Injury Scale | Anatomic grading of bladder wall injury | Widely used, correlates with management | Limited outcome prediction data |
| Clinical classification (intra- vs extraperitoneal) | Guides operative vs nonoperative | Direct impact on management | Does not quantify severity within category |
| EAST/WSES Guidelines | Evidence-based management | Incorporates AAST elements | Very low quality evidence base |
Related Scores in Practice
In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the AAST Kidney Injury Scale, AAST Splenic Injury Scale, Revised Trauma Score (RTS), or the Injury Severity Score (ISS) to formulate a comprehensive care plan.
Last Comprehensive Review: 2026