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Johansen 1990 Mangled Extremity Severity Score (MESS): caller-assigned skeletal/soft-tissue energy 1-4, limb ischemia 1-3 (doubled if ischemia time >6 hours), shock 0-2, and age points (<30 → 0, 30-50 → 1, >50 → 2). Max 14. MESS ≥7 predicted amputation with 100% accuracy in that series (mess_band 0-6 or >=7). Deterministic published arithmetic with citation. Not an amputation or limb-salvage protocol; magent does not examine the limb. Not later papers' cutoff of 8.

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