Evidence map›Paper›PMID 34656726›Full record

ArticleAnnals of vascular surgery2022

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

Angela Aguirre, Kritika Sharma, Aman Arora, Misty D Humphries

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of vascular surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Angela AguirreDivision of Vascular and Endovascular Surgery, University of California Davis Health, Sacramento, CA.
Kritika SharmaDivision of Vascular and Endovascular Surgery, University of California Davis Health, Sacramento, CA.
Aman AroraDivision of Vascular and Endovascular Surgery, University of California Davis Health, Sacramento, CA.
Misty D HumphriesDivision of Vascular and Endovascular Surgery, University of California Davis Health, Sacramento, CA. Electronic address: mdhumphries@ucdavis.edu.
University of California, Davis · US

Funding

Evaluating Implementation of Comprehensive Assessment and Telemedicine Consultation to Prevent Amputations for Patients with Lower Extremity Ulcers in Rural Health Clinics.K23HL143178 · NHLBI · UNIVERSITY OF CALIFORNIA AT DAVIS · PI HUMPHRIES, MISTY DAWN · 2019 to 2023
$788k
NHLBI NIH HHS K23 HL143178
6 · The paper itself

Abstract

backgroundPatients with lower extremity wounds from diabetes mellitus or peripheral artery disease (PAD) have a risk of amputation as high as 25%. In patients with arterial disease, revascularization decreases the risk of amputation. We aimed to determine if the early assessment of arterial perfusion correlates with the risk of amputation.

methodsWe retrospectively reviewed patients referred to the vascular clinic over 18 months with Rutherford Grade 5 and 6 chronic limb-threatening ischemia to determine if patients had a pulse exam done at the time the wound was identified and when ankle brachial index (ABI) testing to evaluate perfusion was performed. Kaplan Meier analysis was used to determine if the timing of ABI testing affected the time to revascularization, wound healing, and risk of amputation.

resultsNinety-three patients with lower extremity wounds were identified. Of these, 59 patients (63%) did not have a pulse exam performed by their primary care provider when the wound was identified. Patients were classified by when they underwent ankle brachial index testing to assess arterial perfusion. Twenty-four had early ABI (<30 days) testing, with the remaining 69 patients having late ABI testing. Patients in the early ABI group were more likely to have a pulse exam done by their PCP than those in the late group, 12 (50%) vs. 22 (32%), P = 0.03. Early ABI patients had a quicker time to vascular referral (13 days vs. 91 days, P < 0.001). Early ABI patients also had quicker times to wound healing than those in the late group (117 days vs. 287 days, P < 0.001). Finally, patients that underwent early ABI were less likely to require amputation (Fig. 1), although this did not reach statistical significance (P = 0.07).

conclusionsEarly ABI testing expedites specialty referral and time to revascularization. It can decrease the time to wound healing. Larger cohort studies are needed to determine the overall effect of early ABI testing to decrease amputation rates.

Indexed as

Ankle Brachial IndexAgedAged, 80 and overAmputation, SurgicalChronic DiseaseDiabetic AngiopathiesFemaleHumansIschemiaLeg UlcerLimb SalvageMaleMiddle AgedPeripheral Arterial DiseasePredictive Value of TestsReferral and ConsultationABIAnkle brachial indexchronic limb-threatening ischemiaCLICLTIcritical limb ischemiaPADPeripheral artery disease

Identifiers

PMID34656726
PMCPMC9889134
OpenAlexW3207513838

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.