The Relevance of Mangled Extremity Severity Score to Predict Amputation: A Systematic Review

Abstract

BACKGROUND: Amputation is one of the most common surgical procedures in the world. One of the criteria for assessing amputation is the mangled extremity severity score (MESS). The MESS criterion has been used for many years, but the accuracy remains unknown. The aim of this study is to know the accuracy of MESS. METHOD: Keywords of “relevance,” “mangled extremity score,” and “amputation,” and its combination were entered into the PubMed database. Four evaluators reviewed articles from the past 5-year publication date with the English language to select relevant articles. RESULTS: The outcomes of this systematic review are the sensitivity and specificity of several scoring tools to predict amputation and recommendations for MESS use. The author identified 26 relevant articles with MESS to predict amputation, and most of them recommend using MESS. The sensitivity and specificity of MESS were variable from 63–73% to 70–76%. CONCLUSION: The MESS performs better in the amputation prediction of the lower extremity arterial injury. Other scoring recommendations are LogisticReg + Nearmiss, ISS, BN, and GHOIS.