Early ABI Testing May Decrease Risk of Amputation for Patients With Lower Extremity Ulcers.

Area of Science:

• Vascular Surgery
• Podiatry
• Diabetic Foot Care

Background:

• Lower extremity wounds in diabetic or PAD patients carry a high amputation risk (up to 25%).
• Revascularization is key in managing arterial disease to prevent amputation.
• The correlation between early arterial perfusion assessment and amputation risk requires investigation.

Purpose of the Study:

• To determine if early assessment of arterial perfusion correlates with amputation risk.
• To evaluate the impact of timing of ankle-brachial index (ABI) testing on patient outcomes.
• To analyze the relationship between ABI testing and revascularization, wound healing, and amputation rates.

Main Methods:

• Retrospective review of 93 patients with Rutherford Grade 5 and 6 chronic limb-threatening ischemia.
• Analysis of pulse exam documentation and timing of Ankle-Brachial Index (ABI) testing.
• Kaplan-Meier analysis to assess the effect of ABI testing timing on revascularization, wound healing, and amputation.

Main Results:

• 63% of patients lacked a pulse exam by primary care providers upon wound identification.
• Early ABI testing (<30 days) was associated with more frequent pulse exams (50% vs 32%).
• Early ABI testing led to faster vascular referral (13 vs 91 days) and wound healing (117 vs 287 days).

Conclusions:

• Early Ankle-Brachial Index (ABI) testing accelerates specialty referral and revascularization.
• Prompt ABI assessment can significantly decrease wound healing times.
• Larger studies are necessary to confirm the impact of early ABI testing on reducing amputation rates.