Outcomes of severe lower limb injury with Mangled Extremity Severity Score ≥ 7.

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Abstract

[Indexed for MEDLINE] 15. World J Surg. 2020 Mar;44(3):773-779. doi: 10.1007/s00268-019-05263-w. The Mangled Extremity Severity Score Fails to be a Good Predictor for Secondary Limb Amputation After Trauma with Vascular Injury in Central Europe. Hohenberger GM(1), Konstantiniuk P(2), Cambiaso-Daniel J(3), Matzi V(4), Schwarz AM(5), Lumenta DB(3), Cohnert TU(2). Author information: (1)Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria. hohenberger.gloria@gmail.com. (2)Division of Vascular Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/4, 8036, Graz, Austria. (3)Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Auenbruggerplatz 29/4, 8036, Graz, Austria. (4)Department of Surgery, State Hospital Leoben, Vordernberger Straße 42, 8700, Leoben, Austria. (5)AUVA Trauma Hospital Graz, Göstinger Straße 24, 8020, Graz, Austria. 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