背景：经修订的美国创伤外科协会（AAST）脾损伤器官损伤量表（OIS）纳入了放射学特征，但其含义尚不清楚。我们假设修订后的AAST-OIS会更好地预测结果。
方法：回顾了2016年至2021年I级创伤中心收治的钝性脾损伤患者。灵敏度,特异性，使用两种模式计算高级别损伤(AAST-OISIV-V级)的脾切除术的阳性预测值(PPV)和阴性预测值(NPV).
结果：在分析的852例患者中，观察到48.5%，24.6%被栓塞，其余患者接受手术干预。AAST-OIS中位数从II增加到III（p<0.01）。敏感度（38.0%vs.73.7%）和净现值（80.9%与对于严重损伤，脾切除术的88.2％）增加，但特异性（93.5％vs70.1％）和PPV（67.5％vs46.7％）降低。
结论：修正后的AAST-OIS能更好地预测脾挽救，但在预测脾切除需要时准确性较差。
BACKGROUND: The revised American Association for the Surgery of Trauma (AAST) organ injury scale (OIS) for splenic injury incorporates radiologic features but the implications of this are unknown. We hypothesized that the revised AAST-OIS would better predict outcomes.
METHODS: Patients with a blunt splenic injury admitted to a Level I trauma center were reviewed from 2016 to 2021. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for splenectomy were calculated for high-grade injuries (AAST-OIS grades IV-V) using both schemas.
RESULTS: Of the 852 patients analyzed, 48.5% were observed, 24.6% were embolized, and the remaining underwent operative intervention. The median AAST-OIS increased from II to III (p < 0.01). Sensitivity (38.0% vs. 73.7%) and NPV (80.9% vs. 88.2%) for splenectomy increased for high-grade injuries but specificity (93.5% vs 70.1%) and PPV (67.5% vs 46.7%) decreased.
CONCLUSIONS: The revised AAST-OIS better predicted splenic salvage but is less accurate at predicting need for splenectomy.
