Vol. 48 | No. 2 | July-December 2020 Back

Open Access

A Comparative Study on the Alternative Ankle Brachial Index (ABI) Method Versus the Traditional ABI Method Among Screened Patients: A 1-year Retrospective Review

Keith Andrew L. Chan, Jeremy Anne A. Alcazar, Carlo Andrew A. Buaya, Elaine L. Gallardo 
Dec 2020 DOI 10.69944/pjc.2832a9b7bf

Abstract

BACKGROUND: Peripheral artery disease (PAD) of the lower extremities is a chronically  progressive disorder characterized by the presence of arterial occlusion. Screening for PAD by  the Ankle–Brachial Index (ABI) is recommended and traditionally computed using the higher  ankle pressure divided by the higher brachial pressure. Alternative methods that utilize the lower  pressure of the pressures have been proposed with the premise of reclassifying a greater number  of at-risk individuals. 

METHODS: This study is a retrospective analysis. Data from inpatients screened for ABI from  March 1, 2018, to March 31, 2019, were included. All ABIs were computed via traditional  methods, with all abnormal ABIs (<0.9) grouped accordingly (ABI A). The remaining patients were  then retested using the alternative method, and those with abnormal ABIs were then grouped  (ABI B). The remaining patients were designated to have normal ABIs. Patients assessed as  outpatients and those with incomplete clinical information or with ABIs of greater than 1.4 were  excluded. Differences among the clinical parameters among groups were analyzed via t test or χ2 test (P < 0.05).  

RESULTS: A total of 226 patients were analyzed. Through traditional ABI computation, 18  patients (7.96%) had abnormal values. The remainder had ABIs computed via the alternative  method, with an additional 15 patients (6.64%) having abnormal ABIs, with a significantly higher  percentage of patients having abnormal ABIs with the traditional versus alternative methods  (7.96% vs 14.6%). Patients with abnormal ABIs were significantly older (p = 0.003, p = 0.061),  with patients traditionally screened having higher cholesterol (p = 0.015). All other demographic  and clinical characteristics were similar among all groups. 

CONCLUSION: The alternative ABI method detects a significantly higher number of patients  compared with the traditional method; apart from age and cholesterol, there exist no significant  differences in clinical characteristics among the groups, emphasizing the need for diligent ABI  screening for PAD. 

KEYWORDS: Ankle Brachial Index; Alternative Method ABI; ABI Computation

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