Title

The Futility of Predictive Scoring of Mangled Lower Extremities.

Publication/Presentation Date

1-1-1993

Abstract

Fifty-eight lower limb salvage attempts over a 10-year period were retrospectively scored using the Mangled Extremity Syndrome Index (MESI), Mangled Extremity Severity Score (MESS), Predictive Salvage Index (PSI), and the Limb Salvage Index (LSI). Primary amputations were excluded. Limb salvage failure was defined at four levels, including functional failure 2 years postinjury. Cross-validational sensitivity and specificity analyses revealed no predictive utility in any of the four indices. Although most failed limb salvage attempts could be identified early in the course of management, a significant percentage of our patients suffered prolonged reconstructive efforts. We conclude that efforts must be directed at more precisely determining the factors that aid in the decisions to terminate futile salvage efforts.

Volume

34

Issue

1

First Page

99

Last Page

104

ISSN

0022-5282

Disciplines

Medicine and Health Sciences | Other Medical Specialties | Surgery | Trauma

PubMedID

8437205

Department(s)

Department of Surgery

Document Type

Article