MESS (Mangled Extremitiy Severity Score)

 Anwendung
Hilfe bei Entscheidung zur Amputation
 Anmerkung
MESS Score > 7 - poor limb viability prognosis
   MEDLINE
  
 CaveDie prospektive Studie von Bosse mit 556 Fällen konnte zwar zeigen, niedrige Werte gut mit Gliedmaßenerhalt korrelierten, aber hohe Werte nicht als Prediktoren für eine Amputation genommen werden konnten.

"The analysis did not validate the clinical utility of any of the lower-extremity injury-severity scores. The high specificity of the scores in all of the patient subgroups did confirm that low scores could be used to predict limb-salvage potential. The converse, however, was not true. The low sensitivity of the indices failed to support the validity of the scores as predictors of amputation."
   MEDLINE

 Skeletal /softissue injury
 
 Low energy (stab; simple fracture; pistol gunshot wound)    1
 Medium energy (open or multiple fractures, dislocation)  2
 High energy (high speed MVA or rifle GSW)        3
 Very high energy (high speed trauma + gross contamination)  4
 Limb ischemia 
 Pulse reduced or absent but perfusion normal      1*
 Pulseless; paresthesias, diminished capillary refill       2*
 Cool, paralyzed, insensate, numb             3*
 Shock  
 Systolic BP always > 90 mm Hg         0
 Hypotensive transiently           1
 Persistent hypotension     2
 Age (years)  
 < 30  0
 30-50            1
 > 50          2
  
 * Score doubled for ischemia > 6 hours