Bonanni F, Rhodes M, Lucke J F
Department of Surgery, Lehigh Valley Hospital, Allentown, Pennsylvania.
J Trauma. 1993 Jan;34(1):99-104. doi: 10.1097/00005373-199301000-00019.
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.
在10年期间，对58例下肢保肢尝试进行回顾性评分，采用肢体毁损综合征指数（MESI）、肢体毁损严重程度评分（MESS）、预测保肢指数（PSI）和保肢指数（LSI）。排除一期截肢病例。保肢失败定义为四个水平，包括伤后2年的功能失败。交叉验证敏感性和特异性分析显示，这四个指数均无预测效用。虽然大多数保肢失败尝试在治疗过程早期即可识别，但我们有相当比例的患者经历了长时间的重建努力。我们得出结论，必须致力于更精确地确定有助于决定终止徒劳保肢努力的因素。
