Significance and utility of the ankle-ankle systolic pressure index in inferior limb trauma patients and soft signs of vascular injury

Objectives We pretend to establish the utility of the ankle-ankle systolic pressure index (AAI) in patients with trauma in the inferior limbs and soft signs of vascular injury describing its sensitivity, specificity and predictive values according to the best cut-off point. Material and method The cohort included 120 patients with trauma in the inferior limbs and soft signs of vascular injury who attended the University Hospital of Santander (Bucaramanga, Colombia) over a period of 4 years (2012-2015). Results 21 (17.5%) patients had an ankle brachial pressure index (ABI) < .9 at the admission and they received immediately surgical management, finding vascular injury in the operating room; 2 (1.6%) patients had an ABI < .9 in the 6 h monitoring control and they also received surgical management finding vascular injury. Therefore, we found 23 patients with vascular injury. The ROC curves for the ABI and AAI show that they both have a good achievement for the diagnosis of vascular injury in patients with soft signs when they were used one time. In both cases, the traditionally point of 90 has a good discriminatory capacity with a sensitivity of 91% (95% CI: 71-.98), specificity of 100% (95% CI: 96-1.0), positive predictive value of 100% (95% CI: 83-1.0) and negative predictive value of 97% (95% CI: 92-.99). Conclusion The ankle-ankle systolic pressure index (AAI) allows to rule out vascular injury in the patient with trauma in the inferior limbs and soft signs.