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Correlation of Ankle Brachial Index (ABI) with Degrees of Diabetic Ulcer

Prita Aulia, Chairuddin Rasjad, Jufri Latief, Arifin Seweng, Prihantono Prihantono.


Abstract

Background: Foot ulcer are common complication of Diabetic Mellitus (DM) that has high morbidity and mortality rate and associated with prolonged treatment conditions and increased risk of surgery and amputation. Peripheral arterial disease (PAD) can cause intermittent claudication for the occurrence of foot ulcers in DM. The Ankle Brachial Index (ABI) value can be used as an initial diagnosis for PAD. This study aims to examine the values of ABI in patients with a diabetic foot ulcer and its correlation to diabetic ulcer based on Wagner's classification.
Method: The study design was cross-sectional, from April to June 2018. Demographic, clinical and anthropometric data of diabetic ulcer patients who were hospitalized or outpatient at WahidinSudirohusodo Makassar Hospital were recorded for 41 patients. The degree of injury is assessed based on Wagner's criteria, ABI examination is performed and blood sugar checks are performed using blood sugar check strips. Data analyzed using the Spearman's Correlation and Chi-Square test.
Results: Subject ABI levels were between 0.85-1.33 with mean of 1.14. Clinical examination results showed 18 (43,9%) subjects had normal and 18 (43,9%) had mild ABI and only 5 (12,2%) subjects with moderate degrees. There is correlation between ABI and Wagner classification, even though the statistical test results showed no significance (p>0,08). Percentage of subjects with Wagner III, IV and V was high in mild ABI (i.e. 40.0%, 40.0% and 20.0%), while the percentage of subjects with Wagner I and II were found to be high in normal ABI (27.8% each)
Conclusion: There was correlation between ABI and wagner’s classification, that the lower of ABI value, the higher the degree of wagner’s classification but statistically insignificant

Key words: Diabetes Mellitus, Ankle Brachial index, Neuropathy, Wagner Classification






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