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Comparison of Ankle Brachial Index (ABI), Toe Brachial Index (TBI), and Trans-Cutaneous Partial Pressure of Oxygen (TcPO2) in Prediction of Limb Outcome Among Patients with Diabetic Foot Ulcers (DFUs)

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Abstract

Diabetics develop foot ulcers due to peripheral ischaemia, neuropathy, or nero-ischaemia both. With rising prevalence of peripheral arterial occlusive disease (PAOD), it is considered the most important factor in development of foot ulcer and may subsequently lead to leg amputation among them. Various modalities available to assess the severity of vasculopathy among diabetic patients include measurement of Ankle Brachial Pressure Index (ABI), Toe Brachial Pressure Index (TBI), and Trans-cutaneous Partial pressure of Oxygen (TcPO2). Though, each modality, mentioned above, can predict the limb outcome (ulcer healing/ minor or major amputations) independently, but their predictive abilities are variable in various studies. This was a cross-sectional, observational study conducted over 100 patients with 108 diabetic feet, which has compared the accuracy of ABI, TBI, and TcPO2 in predicting limb outcome among patients with vasculopathy associated foot ulcers among diabetics. Patients who underwent major and minor amputations had mean ABI of 0.54 ± 0.22 and 0.85 ± 0.19, mean TBI of 0.25 ± 0.12 and 0.42 ± 0.26, and mean TcPO2 of 27.08 ± 11.88 and 41.29 ± 22.56 respectively. Out of three modalities, TcPO2 had the maximum predictive ability (AUC — 0.865009) for amputation followed by TBI (AUC — 0.825865). In patients with vaculopathy associated DFUs, TcPO2 is a better predictor of limb outcome when compared to TBI and ABI.

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Authors and Affiliations

  1. Command Hospital (Central Command), Lucknow, India

    Vembu Anand

  2. Department of Surgery, Army Hospital (Research and Referral), New Delhi, India

    Amit Kumar Singh

  3. INHS Asvini, Mumbai, Maharashtra, India

    Amit Pushkarna

  4. Department of Vascular and Endovascular Surgery, INHS Asvini, Mumbai, Maharashtra, India

    Rakesh Kumar Jha

Authors
  1. Vembu Anand
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  2. Amit Kumar Singh
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Contributions

(a) Conceptualization: Dr Vembu Anand, Dr Amit kumar Singh, and Dr Rakesh Kumar Jha.

(b) Design: Dr Amit Kumar Singh, Dr Rakesh Kumar Jha, and Dr Amit Pushkarna.

(c) Definition of intellectual content: Dr Amit Kumar Singh, Dr Vembu Anand, Dr Rakesh Kumar Jha, and Dr Amit Pushkarna.

(d) Literature search: Dr Rakesh Kumar Jha, Dr Amit Kumar Singh, and Dr Amit Pushkarna.

(e) Clinical studies: Dr Vembu Anand, Dr Amit Kumar Singh, Dr Amit Pushkarna, and Dr Rakesh Jha.

(f) Experimental studies: Dr Rakesh Kumar Jha, Dr Amit Kumar Singh, and Dr Vembu Anand.

(g) Data acquisition, data analysis and statistical analysis: Dr Rakesh Kumar Jha, Dr Amit Kumar Singh, and Dr Amit Pushkarna.

(h) Manuscript preparation: Dr Rakesh Kumar Jha and Dr Amit Kumar Singh.

(i) Manuscript editing and manuscript review: Dr Vembu Anand and Dr Amit Pushkarna.

Corresponding author

Correspondence to Rakesh Kumar Jha.

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The research was performed after taking approval from Institutional Ethical and Research Committee and obtaining written informed consent from patients’ prior enrolment.

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Anand, V., Singh, A.K., Pushkarna, A. et al. Comparison of Ankle Brachial Index (ABI), Toe Brachial Index (TBI), and Trans-Cutaneous Partial Pressure of Oxygen (TcPO2) in Prediction of Limb Outcome Among Patients with Diabetic Foot Ulcers (DFUs). Indian J Surg (2023). https://doi.org/10.1007/s12262-023-03933-7

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  • DOI: https://doi.org/10.1007/s12262-023-03933-7

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