{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T08:15:05Z","timestamp":1758269705459},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T00:00:00Z","timestamp":1572825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T00:00:00Z","timestamp":1572825600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T00:00:00Z","timestamp":1572825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The Mangled Extremity Severity Score (MESS) was constructed as an objective quantification criterion for limb trauma. A MESS of or greater than 7 was proposed as a cut\u2010off point for primary limb amputation. Opinions concerning the predictive value of the MESS vary broadly in the literature. The aim of this study was to evaluate the applicability of the MESS in a contemporary civilian Central European cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients treated for extremity injuries with arterial reconstruction at two centres between January 2005 and December 2014 were assessed. The MESS and the amputation rate were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010one patients met the inclusion criteria and could be evaluated for trauma mechanism and injury patterns. The mean MESS was 4.97 (CI 4.4\u20135.6). Seventy\u2010three per cent of all patients (52\/71) had a MESS\u2009&lt;\u20097 and 27% (19\/71) of \u22657. Eight patients (11%) underwent secondary amputation. Patients with a MESS\u2009\u2265\u20097 showed a higher, but statistically not significant secondary amputation rate (21.1%; 4\/19) than those with a MESS\u2009&lt;\u20097 (7.7%; 4\/52; <jats:italic>p<\/jats:italic>\u2009=\u20090.20). The area under the ROC curve was 0.57 (95% CI 0.41; 0.73).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Based on these results, the MESS appears to be an inappropriate predictor for amputation in civilian settings in Central Europe possibly due to therapeutic advances in the treatment of orthopaedic, vascular, neurologic and soft\u2010tissue traumas.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-05263-w","type":"journal-article","created":{"date-parts":[[2019,11,4]],"date-time":"2019-11-04T21:03:05Z","timestamp":1572901385000},"page":"773-779","update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The Mangled Extremity Severity Score Fails to be a Good Predictor for Secondary Limb Amputation After Trauma with Vascular Injury in Central Europe"],"prefix":"10.1002","volume":"44","author":[{"given":"Gloria Maria","family":"Hohenberger","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Trauma Medical University of Graz Auenbruggerplatz 5 8036 Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Konstantiniuk","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Department of Surgery Medical University of Graz Auenbruggerplatz 29\/4 8036 Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janos","family":"Cambiaso\u2010Daniel","sequence":"additional","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery Medical University of Graz Auenbruggerplatz 29\/4 8036 Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronika","family":"Matzi","sequence":"additional","affiliation":[{"name":"Department of Surgery State Hospital Leoben Vordernberger Stra\u00dfe 42 8700 Leoben Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelika Maria","family":"Schwarz","sequence":"additional","affiliation":[{"name":"AUVA Trauma Hospital Graz G\u00f6stinger Stra\u00dfe 24 8020 Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David Benjamin","family":"Lumenta","sequence":"additional","affiliation":[{"name":"Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery Medical University of Graz Auenbruggerplatz 29\/4 8036 Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina Ulrike","family":"Cohnert","sequence":"additional","affiliation":[{"name":"Division of Vascular Surgery, Department of Surgery Medical University of Graz Auenbruggerplatz 29\/4 8036 Graz Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,11,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.01.010"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2008.02.043"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2004.06.017"},{"key":"e_1_2_7_5_1","first-page":"389","article-title":"Civilian traumatic vascular injuries of the upper extremity: report of the Iranian national trauma project","volume":"15","author":"Rasouli MR","year":"2009","journal-title":"Ann Thorac Cardiovasc Surg"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373\u2010199005000\u201000007"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1749\u2010799X\u20104\u20104"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11751\u2010012\u20100137\u20104"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2007.10.038"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/1749\u2010799X\u20105\u201025"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010008\u20109902\u20104"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED.172.7.777"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020\u20101383(02)00214\u20100"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e31819cdcb0"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000767"},{"key":"e_1_2_7_16_1","volume-title":"Polytrauma management","author":"Tscherne H","year":"1997"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9689"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2017.05.022"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001339"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e318299d95e"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2014.02.009"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.17.00131"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/978\u20103\u2010319\u201041406\u20105_17"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2016.12.001"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-019-05263-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-019-05263-w\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-019-05263-w.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-019-05263-w","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,23]],"date-time":"2023-12-23T15:04:10Z","timestamp":1703343850000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-019-05263-w"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,11,4]]},"references-count":23,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2020,3]]}},"alternative-id":["10.1007\/s00268-019-05263-w"],"URL":"https:\/\/doi.org\/10.1007\/s00268-019-05263-w","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,11,4]]},"assertion":[{"value":"4 November 2019","order":1,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the local Ethics Committee (27-460 ex 14\/15) in accordance with the principles of the Declaration of Helsinki and the ICH-GCP Guidelines.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical details"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}