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01-03-2020 | Original Scientific Report

The Mangled Extremity Severity Score Fails to be a Good Predictor for Secondary Limb Amputation After Trauma with Vascular Injury in Central Europe

Authors: Gloria Maria Hohenberger, Peter Konstantiniuk, Janos Cambiaso-Daniel, Veronika Matzi, Angelika Maria Schwarz, David Benjamin Lumenta, Tina Ulrike Cohnert

Published in: World Journal of Surgery | Issue 3/2020

Abstract

Background

The Mangled Extremity Severity Score (MESS) was constructed as an objective quantification criterion for limb trauma. A MESS of or greater than 7 was proposed as a cut-off point for primary limb amputation. Opinions concerning the predictive value of the MESS vary broadly in the literature. The aim of this study was to evaluate the applicability of the MESS in a contemporary civilian Central European cohort.

Methods

All patients treated for extremity injuries with arterial reconstruction at two centres between January 2005 and December 2014 were assessed. The MESS and the amputation rate were determined.

Results

Seventy-one patients met the inclusion criteria and could be evaluated for trauma mechanism and injury patterns. The mean MESS was 4.97 (CI 4.4–5.6). Seventy-three per cent of all patients (52/71) had a MESS < 7 and 27% (19/71) of ≥7. Eight patients (11%) underwent secondary amputation. Patients with a MESS ≥ 7 showed a higher, but statistically not significant secondary amputation rate (21.1%; 4/19) than those with a MESS < 7 (7.7%; 4/52; p = 0.20). The area under the ROC curve was 0.57 (95% CI 0.41; 0.73).

Conclusions

Based on these results, the MESS appears to be an inappropriate predictor for amputation in civilian settings in Central Europe possibly due to therapeutic advances in the treatment of orthopaedic, vascular, neurologic and soft-tissue traumas.

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Title: The Mangled Extremity Severity Score Fails to be a Good Predictor for Secondary Limb Amputation After Trauma with Vascular Injury in Central Europe
Authors: Gloria Maria Hohenberger
Peter Konstantiniuk
Janos Cambiaso-Daniel
Veronika Matzi
Angelika Maria Schwarz
David Benjamin Lumenta
Tina Ulrike Cohnert
Publication date: 01-03-2020
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 3/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-019-05263-w

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The Mangled Extremity Severity Score Fails to be a Good Predictor for Secondary Limb Amputation After Trauma with Vascular Injury in Central Europe

Abstract

Background

Methods

Results

Conclusions

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Abstract

Background

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