Résumé :
|
[BDSP. Notice produite par INIST VR0x0UNs. Diffusion soumise à autorisation]. Background We assessed the value of the medical history and physical examination in the diagnosis of peripheral vascular disease in diabetic subjects. Methods : We performed a cross-sectional study in 631 diabetic veteran enrolleess of a general internal medicine clinic that compared data obtained from a history and clinical evaluations with the presence of severe peripheral vascular disease defined as an ankle-arm index (AAI) 0.5 derived from Doppler blood pressure measurement. Results : We identified 90 limbs with an AAI 0.05. Results presented below apply to the right leg, but do not differ from the left. Diminished or absent foot peripheral pulses (sensitivity 65%, specificity 78%), venous filling time>20 sec (sensitivity 22%, specificity 93,9%), age>65 years (sensitivity 83%, specificity 54%), claudication symptoms in5 sec or foot characteristics (absent hair, blue/purple color, skin coolness, or atrophy) conveyed little diagnostic information. Individual factors did not change disease probability to a clinically important degree. A stepwise logistic regression model identified four factors significantly (p
|