J Korean Soc Spine Surg.  2014 Mar;21(1):36-40. 10.4184/jkss.2014.21.1.36.

Digital Pulse Oximetry for the Screeing of Lower Extremity Arterial Disease

• Shim DM
• Oh SK
• Kwon JN

• KMID: 1840415
• DOI: http://doi.org/10.4184/jkss.2014.21.1.36

Abstract

STUDY DESIGN: Retrospective study.
OBJECTIVES
The aim of the study was to investigate the usefulness of a handheld digital pulse oximetry in the detection of lower extremity arterial disease. SUMMARY OF LITERATURE REVIEW: Pulse oximetry is a well-established method for noninvasive evaluation of arterial oxygenation.
MATERIALS AND METHODS
A Retrospective study was performed in 45 patients with lower extremity arterial disease. We compared the accuracy of a handheld digital pulse oximetry and the ankle brachial index (ABI). Digital pulse oximetry was conducted for 42 patients with 84 limbs to measure the SaO2 of their index fingers and big toes in supine position. The ABI was defined as abnormal if it was less than 0.9. Pulse oximetry of big toes was defined as abnormal if the SPO2 was less than 96% or it was more than 2% lower than that of the index finger.
RESULTS
Digital pulse oximetry had a sensitivity of 47%(95% CI, 34-60%) and specificity of 86%(95% CI, 64-96%). ABI had a sensitivity of 49%(95% CI, 34-64%) and specificity of 95%(95% CI, 72-99%). Positive predictive values were 91%(95% CI, 74-98%) for digital pulse oximetry and 96%(95% CI, 77-99%) for ABI. Negative predictive values were 37%(95% CI, 24-51%) for digitial pulse oximetry and 43%(95% CI, 25-72%) for ABI. In 22 cases with acute ischemicwere the sensitivity 73%, the specifity 100%, the positive predictive value 100% and the negative predictive value 79%.
CONCLUSIONS
Handheld digital pulse oximetry of the big toes seems as accurate as ABI to detect lower extremity arterial diseases. The combination of both will help to distinguish low extremity arterial disease and spinal radiculopathy.

Keyword

arterial disease; pulse oximetry; ankle brachial index

MeSH Terms

Ankle Brachial Index
Extremities
Fingers
Humans
Lower Extremity*
Oximetry*
Oxygen
Radiculopathy
Retrospective Studies
Sensitivity and Specificity
Supine Position
Toes
Oxygen

Figure

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  Fig 1. Handheld digital pulse oximetry.

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  Fig 2. Receiver operating characteristic (ROC) curve for the pulse oximetry test and the ankle brachilaindex(ABI). (A) ROC curve for pulse oximetry test, Area under the curve was 0.321 (95% confidence interval:0.205-0.438,p<0.014). (B) ROC curve for ABI, Area under the curve was 0.375 (95% confidence interval:0.246-0.505,p<0.114).

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