Abstract 286: Concordance Between Ankle-Brachial Index Measurement Methods (Palpatory Versus Doppler)
Peripheral arterial disease (PAD) is one of the manifestations of atherosclerosis and its detection is commonly made by ultrasound Doppler screening to estimate the ankle brachial index (ABI). However, this method may be unavailable in developing countries with low diagnostic resources. Measurement of the ABI via a palpatory method offers an inexpensive, readily available alternative approach for early disease detection of PAD.We measured the ABI in 186 patients (48% male, mean age 65 SD 12.5), prospectively hospitalized in an Internal Medicine ward (HGSJDD in Guatemala City, Guatemala) for unrelated reasons and no previous diagnosis of PAD. Two independent observers then performed ABI measurement via either a palpatory or Doppler method on all patients. The palpatory method involved digital palpation of foot arteries and use of a calibrated mercury sphygmomanometer. The Doppler technique was performed using a 8 MHz probe and the same calibrated sphygmomanometer. PAD cases were identified as having an ABI < 0.9. A total of 36 cases of abnormally low ABI (positive for PAD) were identified by Doppler method (19.4% prevalence). Of these, 30 were also appropriately identified as positive cases by the palpatory method. A total of 150 normal range ABI's were identified by Doppler method, and of these, 145 were concomitantly also categorized as normal by the palpatory method. Overall, we found a 94.1 % concordance rate (175 of 186 paired categorizations). The Cohen's kappa coefficient was determined to be 0.808, and in comparison to the gold standard Doppler method, the sensitivity and specificity of the palpatory method was 83% and 96%, respectively. We conclude that the palpatory method is a reliable method to measuring ABI in medical patients, particularly in resource restrained settings.
Author Disclosures: M.A. Orellana-Barrios: None. J.C. Penagos-Cordon: None. L.M. Cifuentes-Escobar: None. E.R. Rodriguez-De Leon: None. A.E. Perez-Jordan: None. E.A. Oliva-Gonzalez: None.
- © 2014 by American Heart Association, Inc.