Application of the L-Dex Score for the Assessment of Bilateral Leg Edema

We evaluated a modified L-Dex score by using the right arm as a reference (LDS_rarm), to determine whether it could be used for the assessment of leg edema in place of the usual L-Dex score calculated by using the contralateral normal leg as a reference (LDS_cont).

Bioimpedance analysis was performed in the legs and right arms of 38 patients with unilateral leg edema and in 42 healthy volunteers by using a standard equipotential electrode arrangement.

The impedance ratio in the right arms of patients (2.6 ± 0.4) was lower than that in their contralateral normal legs (3.0 ± 0.8, p < 0.05), but it was similar to that in the legs (right: 2.4 ± 0.7, left 2.5 ± 0.8) of normal subjects. There was a significant correlation between LDS_cont and LDS_rarm in legs with edema (right: r = 0.80, left: r = 0.93). No such correlation was found in the legs of normal subjects, but the mean ± 2 standard deviation of their LDS_rarm ranged from -3 to 37, which was similar to LDS_rarm values in legs with edema corresponding to the normal range of LDS_cont (-10 to 10), that is, from 1 to 34.

LDS_rarm could be used as an alternative for LDS_cont in the assessment of leg edema.