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Year :2019
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Month :
October
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Volume :
8
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Issue :
4
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Page :
SO01 - SO03
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Utility of Palpatory Ankle Brachial Pressure Index as a Screening Tool for Asymptomatic Peripheral Vascular Occlusive Disease in Type II Diabetes Mellitus Patients in a Rural Hospital
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Correspondence Address :
Amulya Cherukumudi, Sachidananda Prabhu, Ankeeta Menona Jacob,
Dr. Amulya Cherukumudi,
Department of General Surgery, KS Hegde Medical Academy, Deralakatte, Mangaluru-575018, Karnataka, India.
E-mail: amulyac1@yahoo.com
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Introduction: Introduction: Peripheral Artery Disease (PAD) or Peripheral Vascular Occlusive Disease (PVOD) is one of the significant macrovascular complications of diabetes mellitus, hypertension, and chronic smokers. The Ankle Brachial Pressure Index (ABPI) is an easy, non-invasive, and often underutilised tool for diagnosis of PVOD, which is often underdiagnosed in rural health care settings.
Aim: To estimate the ABPI and determine the proportion of asymptomatic PAD, sensitivity, and specificity of ABPI in patients with type II diabetes mellitus is a rural secondary care hospital.
Materials and Methods: A cross-sectional descriptive study was done on 112 patients presenting to a rural secondary care hospital affiliated to a medical college in Mangalore, Karnataka, India, with type II diabetes mellitus between October 2018 to February 2019. A pre-structured proforma was used to collect data on variables. ABPI measurements were expressed in terms of median and Interquartile range. Age, sex, co-morbidity pattern was shown in terms of percentages and proportions. Data was entered in MS Excel and analysed using SPSS software version 20.0. Receptor Operating Characteristic (ROC) curve was used to determine the sensitivity and specificity of ABPI as a screening tool for PVOD.
Results: Of the 112 patients examined, median Ankle Systolic Blood Pressure was 140.0 mmHg (130.0-150.0), and median Brachial Blood Pressure was 139.0 mmHg (130.0-153.5), and the mean ABPI was 1.00±0.15. The number of patients with type II diabetes mellitus with asymptomatic PAD (ABPI <0.9) was 30 (26.8%). However, the sensitivity and specificity of ABPI in the diagnosis of PVOD of type II diabetes mellitus patients was not found to be statistically significant (95% Confidence intervals- 0.390 to 0.660).
Conclusion: Palpatory ABPI has limited utility as a screening tool for PVOD in patients with type II diabetes mellitus. Palpatory ABPI alone is inadequate to diagnose PVOD in high-risk patients.
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