Collins TC, Suarez-Almazor M, Peterson NJ, et al.
Family medicine. Date of publication 2006 Jan 1;volume 38(1):38-42.
1. Fam Med. 2006 Jan;38(1):38-42.
An absent pulse is not sensitive for the early detection of peripheral arterial
disease.
Collins TC(1), Suarez-Almazor M, Peterson NJ.
Author information:
(1)Houston Center for Quality of Care and Utilization Studies, Michael E. DeBakey
VA Medical Center, USA. tcollins@bcm.tmc.edu
BACKGROUND: This study's objective was to determine the test characteristics of
pedal pulse palpation in the diagnosis of peripheral arterial disease (PAD) when
compared to the more widely recommended screening tool, the ankle-brachial index
(ABI).
METHODS: We screened patients > 50 years of age for PAD within primary care
clinics in Houston. PAD was diagnosed by an ABI of <0.9. At each visit, pedal
pulse palpation was performed for each leg. Of the patients who screened positive
for PAD by ABI, we determined the sensitivity, specificity, and positive
predictive value of pulse palpation.
RESULTS: We enrolled 403 patients with a mean age of 63.8 +/- .36 years. The
prevalence of PAD was 16.6% (67 patients total). Of the 45 patients with disease
involving their left leg, 37 (82.2%) had a palpable pulse. Of the 37 patients
with disease involving their right leg, 25 (67.6%) had a palpable pulse. The
sensitivity of a non-detectable pulse for the diagnosis of PAD was 17.8% and
32.4% for the left leg and the right leg, respectively. The specificity of pulse
palpation for the detection of PAD was 98.7% and 97.8% for the left leg and the
right leg, respectively.
CONCLUSIONS: Pulse palpation is not sensitive for the detection of PAD compared
to ABI. More than two thirds of the patients within our cohort with PAD of either
the left or right leg had a detectable pulse.
PMID: 16378257 [Indexed for MEDLINE]
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