• Patient Assessment Committee

    The AAST Patient Assessment Committee is focused on developing systems to measure disease severity and patient outcomes for research and quality improvement in acute care surgery.  This past year, we have continued to forward the state of knowledge for emergency general surgery and reviews the AAST Organ Injury Scales for solid organs.

    One of our largest projects in the past five years has been to define the scope and burden of emergency general surgery diseases (EGS) in the United States and to create an anatomic grading scale for EGS diseases that is intuitive and that can be used for both clinical and research purposes.  Anatomic severity of illness scales have been described for 20 of the most common EGS conditions, and many of these scales have been externally validated.  In addition, we have created EGS guideline summaries and have helped create a framework for EGS risk stratification.

    Our committee has also created a draft of an EGS Optimal Resources Document, which is similar to the trauma optimal resources document.  We have been working with a group led by the American College of Surgeons David Hoyt, Raul Coimbra, and multiple stakeholders from other organizations to edit the document as well as determining the feasibility of a verification/certification process for EGS.  This also includes an EGS registry/data standards project; these elements have been identified and the data dictionary is being created with the ACS, to align language with similar quality data standards, such as NSQIP and TQIP.

    Some of our new and ongoing projects include a multi-centered prospective clinical trial of cholecystitis; a collaborative effort with ACS COT members to perform a guidelines gap analysis and identify key areas for guideline summaries in trauma; and a survey of vascular trauma that will be forthcoming this year.  Our group also welcomes any suggestions for projects and papers.

    In summary, I would like to thank all the hard-working members of the Patient Assessment Committee, the Board of Managers, and Ms. Sharon Gautschy, and Ms. Brea Sanders for their invaluable support.  Thank you for the opportunity to highlight our work!


    AAST Patient Assessment Committee Publications, 2013-2018

    1. Aziz H, Lunde J, Barraco R, Como J, Cooper Z, Hayward T, Hwang F, Lottenberg L, Mosenthal A, Mukherjee K, Nash J, Robinson B, Staudenmayer K, Wright R, Yon J, Crandall M.  Evidence-based review of trauma center care and routine palliative care processes for geriatric trauma patients (in press for Journal of Trauma and Acute Care Surgery)
    2. Kozar RA, Crandall M, Shanmuganathan K, Zarzaur B, Coburn M, Cribari C, Kaups K, Schuster K, Tominaga G, & the AAST Patient Assessment Committee. Organ Injury Scaling 2018 update: spleen, liver, and kidney (in press for Journal of Trauma and Acute Care Surgery)
    3. Schuster K, Holena D, Salim A, Savage S, Crandall M. American Association for the Surgery of Trauma emergency general surgery guideline summaries 2018: acute appendicitis, acute cholecystitis, acute diverticulitis, acute pancreatitis, and small bowel obstruction (in press for Trauma Surgery Acute Care Open)
    4. Hernandez M, Madbak F, Parikh K, Crandall M.  GI surgical emergencies: scope and burden of disease (in press for Journal of Gastrointestinal Surgery)
    5. Havens JM, Columbus AB, Brown CVR, Tominaga G, Mowery NT, Crandall M. Risk stratification tools in emergency general surgery Trauma Surgery and Acute Care Open 2018;3(1):e000160. Doi: 10.1136/tsaco-2017-000160
    6. Hernandez M, Havens J, Shafi S, Crandall M.  Risk assessment in emergency general surgery Journal of Trauma and Acute Care Surgery 2018;84(6):956-62
    7. Tominaga GT, Brown CVR, Schulz JT, Barbosa R, Agarwal S, McQuay N, Utter G, Crandall M.  Uniform grading of hemorrhagic emergency general surgery diseases Journal of Trauma and Acute Care Surgery 2018;84(4):670-3.
    8. Utter G, Schuster K, Miller P, Mowery N, Agarwal S, Winchell R, Crandall M. The capacity of ICD-10-CM/PCS to characterize surgical care Journal of Trauma and Acute Care Surgery 2017;83(5):894-8
    9. Wandling M, Ko C, Bankey P, Cribari C, Cryer HG, Diaz J, Duane T, Hameed M, Hutter M, Metzler M, Regner J, Reilly P, Reines HD, Sperry J, Staudenmayer K, Utter G, Crandall M, Bilimoria K, Nathens A.  Expanding the scope of quality measurement in surgery to include non-operative care: results from the ACS NSQIP Emergency General Surgery Pilot Journal of Trauma and Acute Care Surgery 2017;83(5):837-45
    10. Tominaga G, Shafi S, Schuster K, Savage S, Ross S, Miller P, Muskat P, Mowery N, Cohen M, Ciesla D, Inaba K, Brown C, Agarwal S, Aboutanos M, Crandall M.  The American Association for the Surgery of Trauma grading scales for 16 emergency general surgery conditions: disease-specific criteria characterizing anatomic severity Journal of Trauma 2016;81(3):593-602
    11. Shafi S, Priest E, Klekar C, Crandall M, Aboutanos M, Agarwal S, et al. Multicenter validation of American Association for the Surgery of Trauma grading system for acute colonic diverticulitis and its use for Emergency General Surgery Quality Improvement Program Journal of Trauma 2016;80(3):405-11
    12. Savage S, Klekar CS, Priest EL, Crandall M, Rodriguez BC, Shafi S. Validating a new grading scale for emergency general surgery diseases Journal of Surgical Research 2015;196(2):264-9
    13. Utter G, Miller P, Mowery N, Tominaga G, Gunter O, Osler T, Ciesla D, Agarwal S, Inaba K, Aboutanos M, Brown C, Ross S, Crandall M, Shafi S. ICD-9-CM and ICD-10-CM mapping of the AAST Emergency General Surgery Disease Severity Scales: conceptual approach, limitations, and recommendations for the future Journal of Trauma 2015;78(5):1059-65
    14. Crandall M, Agarwal S, Muskat P, Ross S, Savage S, Schuster K, Tominaga G, Shafi S. Application of a uniform anatomic grading system to measure disease severity in eight emergency general surgical illnesses  Journal of Trauma 2014;77(5):705-8
    15. Shafi S, Aboutanos M, Brown C, Ciesla D, Cohen M, Crandall M, Inaba K, Miller P, Mowery N and the AAST Committee on Patient Assessment and Outcomes.  Measuring anatomic severity of disease in emergency general surgery Journal of Trauma 2014;76(3):884-7
    16. Shafi S, Aboutanos MB, Agarwal S, Brown CV, Crandall M, Feliciano DV, Guillamondegui O, Haider A, Inaba K, Osler TM, Ross S, Rozycki GS, Tominaga GT for the American Association for the Surgery of Trauma—Committee on Severity Assessment and Outcomes.  Emergency General Surgery (EGS)—Definition and estimated burden of disease Journal of Trauma 2013;74(4):1092-7 


    Committee Members


    • Marie Crandall (2017 - 2020)


    • Gail Tominaga (2017 - 2020)


    • Ali Salim (2016 - 2019)
    • Angela Ingraham (2018 - 2021)
    • Chris Cribari (2016 - 2019)
    • Daniel Holena (2017 - 2020)
    • David Efron (2017 - 2020)
    • Garth Utter (2017 - 2020)
    • Haytham Kaafarani (2017 - 2020)
    • James Booker (2017 - 2020)
    • James Davis (2016 - 2019)
    • Krista Kaups (2017 - 2020)
    • Kristan Staudenmayer (2016 - 2019)
    • Leonard Weireter, Jr. (2016 - 2019)
    • Matthew Moorman (2018 - 2021)
    • Michael O'Mara (2018 - 2021)
    • Michelle McNutt (2017 - 2020)
    • Robert Martin (2017 - 2020)
    • Ronald Simon (2016 - 2019)
    • Suresh Agarwal, Jr. (2018 - 2021)
    • Toby Enniss (2017 - 2020)