| The role of the ankle brachial pressure index in the diagnosis of peripheral arterial injury. | |
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MedLine Citation:
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PMID: 19779984 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Angiography is the "gold standard" diagnostic tool for patients presenting soft signs of arterial injury. To reduce the number of unnecessary angiographies, we aimed to evaluate the role of the ankle brachial pressure index (ABPI) in the diagnosis of peripheral arterial injury in extremity trauma with soft signs. METHODS: The data of 1772 patients with the suspicion of peripheral arterial injury was recorded prospectively. Two hundred eighty-three patients (16%) with any hard sign underwent immediate surgery. ABPI was calculated in 1489 patients with soft signs. Patients with ABPI <1 were evaluated by duplex ultrasonography and/or angiography, and if arterial injury was detected, the patients underwent surgery. Patients with an ABPI > or =1 were followed up conservatively. RESULTS: 1343 (90%) patients had ABPI > or =1; seven (0.5%) of them developed symptoms and signs of arterial injury and healed without morbidity. One hundred forty-six (10%) patients had ABPI <1; with DUS/angiography, arterial injury was detected in 39 of them (26.7%), and they underwent surgery. The sensitivity of ABPI <1 was 84.8%; specificity 92.6%; positive predictive value 26.7%; negative predictive value 99.5%; and overall accuracy 92.3%. CONCLUSION: ABPI excludes arterial injury in 99.5% of patients with soft signs of arterial injury and avoids unnecessary examinations in 90% of patients. In the management of extremities with soft signs, ABPI measurement should be the first-line diagnostic choice. |
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Authors:
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Mehmet Kurtoğlu; Kemal Dolay; Burçin Karamustafaoğlu; Hakan Yanar; Muharrem Kuzkaya |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES Volume: 15 ISSN: 1306-696X ISO Abbreviation: Ulus Travma Acil Cerrahi Derg Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-09-25 Completed Date: 2009-10-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101274231 Medline TA: Ulus Travma Acil Cerrahi Derg Country: Turkey |
Other Details:
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Languages: eng Pagination: 448-52 Citation Subset: IM |
Affiliation:
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Department of General Surgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Ankle Brachial Index* Arteries / injuries*, surgery Extremities / blood supply* Female Humans Male Middle Aged Peripheral Vascular Diseases / diagnosis*, surgery Predictive Value of Tests Prospective Studies Sensitivity and Specificity Trauma Severity Indices Wounds, Nonpenetrating Wounds, Penetrating Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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