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Metas de Enfermería

Metas de Enfermería

JUNIO 2013 N° 5 Volumen 16

Determination of peripheral arteriopathy by different methods in Primary Care

Section: Featured Articles

How to quote

Medrano Jiménez R, Vallejo Domingo A, Pera Blanco G, Martínez Gallardo I, Jiménez Sánchez MI, Hernández Berriel MB. Determinación de arteriopatía periférica mediante diferentes métodos de Atención Primaria. Metas Enferm 2013; 16(5):7-11.

Authors

1Rafael Medrano Jiménez, 1Antonio Vallejo Domingo, 2Guillem Pera Blanco, 1Isabel Martínez Gallardo, 3Mª Isabel Jiménez Sánchez, 1Mª Begoña Hernández Berriel

Position

1Enfermero/a. ABS 7 Badalona Institut Català de Salut.2Doctorando. Unitat de Suport a la Recerca Metropolitana Nord, Institut d’investigació en Atenció Primària IDIAP Jordi Gol, Mataró.3Enfermera. ABS Sitges Institut Català de Salut.4Enfermera. Centro Salud Titerroy II Servicio Canario de Salud. Representando al Grupo del Estudio ARSEDI.

Contact address

Rafael Medrano Jiménez. Pasatge dels Encants, s/n. 08916 Badalona.

Contact email: abspie@yahoo.es

Abstract

Objectives: to determine the level of agreement in identification of arterial alterations in patients with Type 2 Diabetes Mellitus (DM), through the signs of Pedal Pulse (PP) palpation, Plantar Ischemia (PI) and Venous Capillary Refill (VCR), and the reference value of Ankle-Arm Index (AAI), as well as the prognostic value of these signs and the connection between VCR and diabetic microvascular complications established in the studied population.
Design: multicenter descriptive study. Setting: 16 Primary Care centers. Target population: 5524 patients with DM2, and probabilistic sampling of 804 patients of both genders, over 40-year-old, selected through phone call. The presence of exclusion criteria has been ruled out.
Descriptive analysis in percentages. Student’s t-test for continuous varia­bles, ?2 test for categorical variables. Sensitivity (S), specificity (SP), Positive Predictive Value (PPV) and Negative Predictive Value (NPV).
Results: 58% of the sample were men, median age 67.5 years (DE ± 9,76). Altered AAI in 226 (28.1%) (CI 95% 25%-31%); altered PP in 62 (p= < 0.001); S 27.4%; SP 89,8%, PPV 51,2%, NPV 76%. Altered VCR in 53 (p= < 0.001), S 23.5%; SP 90.7%; PPV 49.5%; NVP 75.2%. PI present in 88 (p= 0.035), S 38.9%; SP 68.9%; PPV 32.8%; NPV 74.3%. Altered VCR vs. neuropathy: 16 of 36 (p= < 0.001); vs. nephropathy: 19 of 75 (p= 0.001); vs. retinopathy 15 of 74 (p= 0.064).
Conclusions: signs are directly proportional to stenosis and inversely proportional in calcifications. More studies are needed in order to ensure that altered VCR represents microvascular alteration.

Keywords:

ankle-arm index; capillary venous refill; pedal pulse; peripheral arteriopathy; plantar ischemiaPrimary Care

Versión en Español

Título:

Determinación de arteriopatía periférica mediante diferentes métodos en Atención Primaria