title: Application of the Mangled Extremity Severity Score in a combat setting.
abstract: OBJECTIVE
  The aim of this study was to examine the Mangled Extremity Severity Score (MESS) in a combat setting.
  
  
  METHODS
  Data on extremity injuries were collected from a forward surgical team. MESS and Revised Trauma Score values were retrospectively calculated for each patient. Student's t test was used to compare amputated and salvaged limbs.
  
  
  RESULTS
  A total of 60 extremities was identified in 49 patients. There were 10 major vascular repairs (20%). MESS values differed significantly for the eight amputations performed (mean MESS, 7.87 +/- 1.91) and 50 salvaged extremities (mean MESS, 2.44 +/-_ 0.438; p = 0.001).
  
  
  CONCLUSIONS
  A MESS of >7 correlated with amputation, thus validating the MESS in a combat setting. A young average patient age and high-energy injury mechanism on the battlefield leave ischemic time and shock as the most important factors in dictating whether a MESS is >7 or <7.
authors: Department of Surgery, Madigan Army Medical Center, Tacoma, WA 98431, USA.
authors: Robert M
authors: RM
authors: Rush
authors: Randy
authors: R
authors: Kjorstad
authors: Benjamin W
authors: BW
authors: Starnes
authors: Edward
authors: E
authors: Arrington
authors: John D
authors: JD
authors: Devine
authors: Charles A
authors: CA
authors: Andersen
mesh_terms: D000328:Adult; D000674:Amputees; D006801:Humans; D015601:Injury Severity Score; D023821:Limb Salvage; D008297:Male; D008887:Military Medicine; D008889:Military Personnel; D012720:Severity of Illness Index; D014218:Triage; D014481:United States; D014857:Warfare; D014947:Wounds and Injuries