A STUDY OF USE OF COMPUTED TOMOGRAPHY ANGIOGRAPHY AND MANGLED EXTREMITY SEVERITY SCORE AS PREDICTORS OF LIMB SALVAGE IN EXTREMITY VASCULAR TRAUMA

Abstract

Back Ground:Major loss of limb and life remains as an increasing importance as the occurances of arterial injuries are increasing . The prevention of such events and accurate identification of the limbs at risk, remains our serious concern. Introduction: There has been a longtime search for definitive score or test for evaluation of patients with vascular injuries. Mangled Extremity Severity Score (MESS) has been proved as predictor of viable limbs and Computed tomography Angiography (CTA) as an essential tool in diagnosing arterial injury. We did this study in India , combining MESS and CTA for predicting outcomes of arterial injury of extremity trauma victims in our hospital . Methods: A prospective,observational study of limb injuries between 2016 and 2018 in trauma unit was performed.We examined the clinical signs, operative findings using Mangled Extremity Severity Score and Computed tomography Angiography at presentation and compared with resultant limb salvage outcome. Results:Out of 100 people , 70 people fulfilled the inclusion criteria . Our study resulted an accuracy of 94.3% indicating perfect predictive ability of limb salvage by using the MESS score. CT angiography as the predictable variable and limb salvage as outcome variable showed an accuracy of prediction was 92.9% and excellent predictable accuracy of 97.1% when combining MESS with CTA. Conclusions:Combining clinical assessment using MESS and CTA improves the diagnostic accuracy of vascular injury and the need for immediate intervention for limb salvage procedures, and prevents amputation by delay.