Durham R M, Mistry B M, Mazuski J E, Shapiro M, Jacobs D
Department of Surgery, St. Louis University Medical Center, Missouri 63110-0250, USA.
Am J Surg. 1996 Nov;172(5):569-73; discussion 573-4. doi: 10.1016/S0002-9610(96)00245-0.
The role of scoring systems as predictors of amputation and functional outcome in severe blunt extremity trauma was examined.
All severe extremity injuries treated over a 10-year period were scored retrospectively using four scoring systems: Mangled Extremity Syndrome Index (MESI), Mangled Extremity Severity Score (MESS), Predictive Salvage Index (PSI), and Limb Salvage Index (LSI).
Twenty-three upper (UE) and 51 lower extremity (LE) injuries were evaluated. Sensitivity and specificity, respectively, were MESI 100% and 50%, MESS 79% and 83%, PSI 96% and 50%, and LSI 83% and 83%. For each system, there were no differences between patients with good and poor functional outcomes.
All of the scoring systems were able to identify the majority of patients who required amputation. However, prediction in individual patients was problematic. None of the scoring systems were able to predict functional outcome.
研究了评分系统在严重钝性肢体创伤中作为截肢和功能结局预测指标的作用。
回顾性地使用四种评分系统对10年间治疗的所有严重肢体损伤进行评分：肢体毁损综合征指数（MESI）、肢体毁损严重程度评分（MESS）、预测挽救指数（PSI）和肢体挽救指数（LSI）。
评估了23例上肢（UE）和51例下肢（LE）损伤。敏感性和特异性分别为：MESI为100%和50%，MESS为79%和83%，PSI为96%和50%，LSI为83%和83%。对于每个系统，功能结局良好和不良的患者之间没有差异。
所有评分系统都能够识别出大多数需要截肢的患者。然而，对个体患者的预测存在问题。没有一个评分系统能够预测功能结局。
