Ankle Brachial Index vs Transcutaneous Partial Pressure of Oxygen for Predicting Healing of Diabetic Foot Ulcers with Pe
- PDF / 383,971 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 37 Downloads / 164 Views
ORIGINAL ARTICLE
Ankle Brachial Index vs Transcutaneous Partial Pressure of Oxygen for Predicting Healing of Diabetic Foot Ulcers with Peripheral Arterial Disease: a Comparative Study Salahudheen Thottiyen 1 & Rojan Kuruvilla 1 & Amal George 1 & P Rajan 1 & P Sajan 1 & VC Subhash 1 & Jenimol C. Varghese 1 Received: 2 July 2020 / Accepted: 26 August 2020 # Association of Surgeons of India 2020
Abstract Foot ulcer is a common complication of diabetes mellitus. The co-existence of peripheral arterial disease (PAD) increases the risk of non-healing of the ulcer. Ankle brachial index (ABI) and transcutaneous partial pressure of oxygen (TcPO2) are two tests used to assess the vascularity of the foot, using two different parameters. This study was done to compare the sensitivity, specificity and diagnostic accuracy of ABI and TcPO2 and to find out which of these is a better predictor of healing in diabetic foot ulcers in patients without palpable foot pulses. The hospital-based longitudinal study was done from March 2016 to March 2018 among 121 adult patients diagnosed with diabetic foot ulcer without palpable peripheral pulses who fit the inclusion and exclusion criteria. Vascularity of the foot in these patients was assessed using ABI and TcPO2. The participants were followed up for 3 months, and the healing status was recorded. The mean (SD) age of patients was 64.99 (10.03) years. Out of 121 patients, 89 were men and 32 were women. The mean ABI in healed and non-healed group were significantly different (P value < 0.001). TcPO2 also showed significant difference in healed and non-healed groups (P value < 0.001). The values of 0.65 in receiver operating characteristic (ROC) curve showed optimal sensitivity (86.1%) and specificity (75.5%) for ABI. ROC curve with a TcPO2 cut-off value of 27.5 mmHg had optimal sensitivity (84.7%) and specificity (81.6%). Although sensitivity of TcPO2 and ABI is comparable (84.7% v 86.1%), specificity and diagnostic accuracy are better for TcPO2. Keywords Diabetic foot ulcer . Ankle brachial index . Peripheral arterial disease . Transcutaneous partial pressure of oxygen
Introduction Diabetes mellitus (DM) is the commonest metabolic disorder affecting about 20% of the population in various parts of the world [1]. Prevalence of DM is increasing worldwide. In 2011, 366 million adults had DM worldwide, and by 2030, it is proposed to be 552 million [2, 3]. This exponential increase in DM causes an increase in diabetes-related complications like coronary artery disease (CAD), chronic kidney disease (CKD), cardiovascular accidents (CVA), diabetic foot and peripheral arterial disease (PAD). The incidence of DM is increasing worldwide because of increased life expectancy and changing dietary habits [4]. Diabetic foot ulcer is a
* Amal George [email protected]; [email protected] 1
Department of General Surgery, Aster Malabar Institute of Medical Sciences (MIMS), Calicut, India
devastating long-term complication of DM [5]. It has been estimated that 15% of all people with d
Data Loading...
