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Órgano Oficial de la Sociedad Mexicana de Angiología y Cirugía Vascular

2006, Number 4

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Rev Mex Angiol 2006; 34 (4)

Result, utility and critical evaluation of the scoring system NISSSA application (Nerve injury, Isquemia, Soft-tissue injury, Shock, and Age of Patient Score) in patients with vascular damage in lower extremities

Sapiéns LMC, Llamas MFJ, Brachet IJO, Sánchez RE, Pulido AJTR

Language: Spanish
References: 14
Page: 134-140
PDF size: 130.21 Kb.


ABSTRACT

Objective: Evaluation of the scoring system NISSSA, as predictor of salvage or amputation in patients with vascular damage in lower extremity.
Material and methods: Patients’ notes were performed to gather data on type of injury, clinical and operative findings in patients who had vascular damage in lower extremity in the emergency service. An analysis of the scoring system was made, giving a prediction in each patient. To examine the validity the sensitivity, the specificity, the positive predictive value, and the negative predictive value were calculated.
Results: 12 patients, all male, were included in the study; The age rank was varied: from 18 to 49 years (average age of 32.4 years). 5 with vascular damage in popliteal area, in these cases, 3 resulted in amputation. 7 with vascular damage in femoral area, in these cases, 2 resulted in amputation. The average score of the 12 patients is 8.25. The average score of the patients underwent amputation is 10.2 and the limbs with good evolution had average score of 6.8. The scoring system gave sensitivity of 80%, specificity 86%, positive predictive value 80%, negative predictive value 86%.
Conclusions: The present study not support the utility of the scoring system for discriminating between limbs requiring amputation and those likely to be salvaged successfully. But it is indisputable the better prediction of a lower extremity with vascular damage.


REFERENCES

  1. Ascher E. Haimovici’s Vascular Surgery. 5ª. Ed. New York: Editor, Enrico Ascher; 2004: 1-7.

  2. Calvin B. Current Therapy in Vascular Surgery. 4o. Ed. St. Louis Missouri: Mosby; 2001: 580-4, 602-5, 614-18, 631-34.

  3. Somasekhar R, Arunanshu B, Ravul J, Lileswar K, Rudraprasad D. Extremity trauma civilian population: a seven-year review from North India. International Journal of the Care of the Injured. 2004: 1-7.

  4. Sansar S, Ashish D, Marya K, Nitesh R, Critical evaluation of mangled extremity severity scoring system in Indian patients. International Journal of the Care of the Injured. 2002: 493-496.

  5. Hoogendoom JM and Weken Chr. The mangled leg decision-making based on scoring system and outcome. European Journal Trauma 2002, 28(1) 1-10.

  6. Rodney M, Bhargay M, Jonh E, Marc S and Donald J. Outcome and Utility of Scoring Systmes in the Management of the Mangled Extremity. Am J Surg. 1996, 172(5): 569-574.

  7. Martines S., Álvarez E., Mendoza O. Espinosa A. Tratamiento de las lesiones traumáticas graves de las extremidades inferiores de acuerdo con la evaluación funcional. Medicina Universitaria abril-junio 2000; 2: 7, 131-6.

  8. Luján A, Llamas F, Ramos C, Hernández G, Lemus C, Brachet O, Espinosa F. Trauma vascular arterial de las extremidades: Resultados a corto, mediano y largo plazos. Revista Mexicana de Angiología septiembre 2002; 30: 3, 81-7.

  9. Bosse M, MacKenzie E, Kellam J, James F. A prospective evaluation of the clinical utility of the lower-extremity injury-severity scores. J B J Surg 2001; 83: 3-14.

  10. McNamara M, Heckma JD, Corlet FG. Severe open fractures of the lower extremity: a retrospective avaluation of the mangled extremity severity score. J Orthopedic Trauma 1994; 8: 2, 81-7

  11. Hoiness P, Roise O: Amputation or reconstruction of a circulatory compromised severely injured extremity? Tidsskrift for Den Norske Laegeforening 1999; 119: (28): 4178-81

  12. Christian K; Seekamp A; Kontopp H. Tscherne, H; Hannover Fracture Scale’ 98—re-evaluation and new perspectives of an established extremity salvage score. International J Inured. 2001; 32: 317-28

  13. Sullivan, ST; Sullivan, M.O; Pasha, N; Shaughnesssy, M; Connor, O; It is possible to predict limb viability in complex Gustilo IIIB and IIIC tibial fractures? A comparasion of two predictive indices. Injury 1997; 28: 9-10, 639-42

  14. Hafez HM, Woolgar J, Robbs JV, Lower extremity arterial injury: Results of 550 cases and review of risk factors associated with limb loss. J Vascular Surg 2001; 33: 1212-19.




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