Correlation of ankle-wrist pressure index with ankle-brachial pressure index to assess lower limb perfusion in diabetic foot ulcer: a pilot study.

IF 1.5 4区医学 Q3 DERMATOLOGY Journal of wound care Pub Date : 2024-07-02 DOI:10.12968/jowc.2021.0024

Ravi Roshan, Natasha Chaudhary, Udit Chouhan, Farhanul Huda, Somprakas Basu

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Abstract

Objective: The presence of peripheral artery disease (PAD) in patients with diabetic foot ulcers (DFUs) is a significant risk factor for chronicity and amputation. Ankle-brachial pressure index (ABPI) is a screening tool for PAD. Brachial systolic pressure measurement, used as a denominator in the calculation of ABPI, produces inaccurate results in patients with obesity and the presence of heavy clothing. The wrist, however, is easily accessible, and the ankle-wrist pressure index (AWPI), if comparable with ABPI, may be useful in screening selected patients. This study aimed to assess the efficacy of AWPI in diagnosing perfusion in DFUs and compare it to ABPI in patients with DFUs.

Method: ABPI and AWPI were calculated by measuring systolic blood pressure in the arteries of the ankle, arm and wrist with a handheld Doppler. Actual perfusion was determined by the presence or absence of PAD by duplex ultrasound.

Results: A total of 46 lower extremities in 41 patients were studied. The prevalence of PAD was 61%. Duplex ultrasound confirmed that the sensitivity of ABPI and AWPI in detecting PAD in patients with DFUs was 67.9% and 71.4% respectively, whereas the specificity of ABPI and AWPI was 94.4% and 88.9% respectively. On receiver operating characteristic analysis, the area under the curve of ABPI and AWPI was 0.804 and 0.795, respectively. A statistically significant positive correlation between ABPI and AWPI was found (r=0.986; p<0.001).

Conclusion: There was a good correlation between ABPI and AWPI over a wide range of values. ABPI and AWPI may have a similar role in predicting perfusion in patients with DFUs. AWPI could be used in place of ABPI in selected patients in whom measuring ABPI may be difficult.

Declaration of interest: The authors have no conflicts of interest to declare.

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用踝腕压力指数与踝肱压力指数评估糖尿病足溃疡患者下肢血流灌注的相关性：一项试验研究。

目的：糖尿病足溃疡（DFU）患者出现外周动脉疾病（PAD）是导致慢性溃疡和截肢的重要风险因素。踝臂压指数（ABPI）是 PAD 的筛查工具。肱动脉收缩压测量用作计算 ABPI 的分母，在肥胖和穿着厚重衣物的患者中测量结果不准确。然而，腕部的压力测量很容易获得，如果踝腕压力指数（AWPI）与 ABPI 具有可比性，则可能有助于筛查选定的患者。本研究旨在评估 AWPI 对诊断 DFU 灌注的有效性，并将其与 ABPI 在 DFU 患者中的应用进行比较：方法：使用手持式多普勒测量脚踝、手臂和手腕动脉的收缩压，计算 ABPI 和 AWPI。实际灌注量通过双工超声检查是否存在 PAD 来确定：结果：共对 41 名患者的 46 个下肢进行了研究。结果：共对 41 名患者的 46 个下肢进行了研究，PAD 患病率为 61%。双相超声证实，ABPI 和 AWPI 检测 DFU 患者 PAD 的敏感性分别为 67.9% 和 71.4%，而 ABPI 和 AWPI 的特异性分别为 94.4% 和 88.9%。接受者操作特征分析显示，ABPI 和 AWPI 的曲线下面积分别为 0.804 和 0.795。在统计学上，ABPI 和 AWPI 之间存在明显的正相关性（r=0.986；p 结论：ABPI 和 AWPI 之间存在良好的相关性：ABPI 和 AWPI 在很大的数值范围内都有很好的相关性。ABPI 和 AWPI 在预测 DFU 患者的血流灌注方面可能具有相似的作用。对于某些难以测量 ABPI 的患者，可以用 AWPI 代替 ABPI：作者无利益冲突需要声明。

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.