| アイテムタイプ |
itemtype_ver1(1) |
| 公開日 |
2024-10-16 |
| タイトル |
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|
タイトル |
Utility of severity scoring systems for mangled upper limb salvage: A systematic review and meta-analysis |
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言語 |
en |
| 著者 |
Yoneda, Hidemasa
Takeda, Shinsuke
Saeki, Masaomi
Iwatsuki, Katsuyuki
Yamamoto, Michiro
Tatebe, Masahiro
Hirata, Hitoshi
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| アクセス権 |
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アクセス権 |
open access |
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アクセス権URI |
http://purl.org/coar/access_right/c_abf2 |
| 権利 |
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|
権利情報 |
© 2024. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/ |
|
言語 |
en |
| 内容記述 |
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内容記述タイプ |
Abstract |
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内容記述 |
Background: The purpose of scoring systems is to aid in the decision-making process of whether to salvage or amputate mangled extremities, but their efficacy for upper limbs is uncertain. In this study, we examined the predictive potential of scoring systems for upper limb salvage. Methods: Two investigators undertook a systematic search of 3 leading databases for English or Japanese literature from 1985, when the first scoring system to evaluate mangled extremities was proposed, until January 2022. To be eligible, studies must have had upper extremity limb salvage or amputation as an outcome, and identified the scoring system used and treatment outcome in individual cases. Results: Ten studies (N = 338) of the Mangled Extremity Scoring System (MESS) were ultimately included in the meta-analysis. The pooled sensitivity and specificity were 0.95 (95 % CI = 0.69–0.99) and 0.81 (0.65–0.91), respectively. The area under the hierarchical summary receiver operating characteristic curve was 0.95 (0.93–0.97). A subgroup analysis showed lower specificity in isolated vascular injuries. Scoring systems other than MESS were ineligible for the quantitative synthesis because none were examined in an adequate number of publications. Conclusion: The pooled sensitivity and specificity for MESS were comparable to those reported for the lower extremities. The specificity suggests that limb salvage was achieved in at least 20 % of the patients whose MESS was above the threshold beyond which amputation is indicated. Given the likelihood of upper extremity functional limitations following amputation and the drawbacks of prostheses, we conclude that current scoring systems poorly predict salvageability of a mangled upper extremity and should not be used to justify amputation. |
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言語 |
en |
| 出版者 |
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出版者 |
Elsevier |
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言語 |
en |
| 言語 |
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|
言語 |
eng |
| 資源タイプ |
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資源タイプresource |
http://purl.org/coar/resource_type/c_6501 |
|
タイプ |
journal article |
| 出版タイプ |
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|
出版タイプ |
AM |
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出版タイプResource |
http://purl.org/coar/version/c_ab4af688f83e57aa |
| 関連情報 |
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|
関連タイプ |
isVersionOf |
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|
識別子タイプ |
DOI |
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|
関連識別子 |
https://doi.org/10.1016/j.injury.2024.111447 |
| 収録物識別子 |
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収録物識別子タイプ |
PISSN |
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収録物識別子 |
00201383 |
| 書誌情報 |
en : Injury
巻 55,
号 4,
p. 111447,
発行日 2024-04
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| ファイル公開日 |
|
|
日付 |
2025-04-01 |
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日付タイプ |
Available |
injury.pdf (990 KB)
