Diagnostic accuracy of ankle-brachial index versus pulse wave index measurements in the diagnosis of peripheral arterial disease in diabetic patients: A retrospective record-based study

<title>Abstract</title> <p> <bold>Background:</bold> Peripheral artery disease (PAD), a macrovascular consequence that raises the risk of lower-extremity amputation and mortality, is common in patients with diabetes. Due to non-compressible vessels, the Ankle Brachial Index (ABI), which is commonly used to evaluate PAD, produces false-negative results. The purpose of this study was to determine whether the pulse wave index (PWI) provides better diagnostic accuracy than ABI for the early detection of PAD in diabetics. <bold>Methods:</bold> Electronic file system registrations from a vascular surgery outpatient clinic at As-Salam Hospital in Port Said, Egypt, were used in a retrospective record-based investigation. Patient demographics, glycemic control (HbA1c), and current comorbidities were all included in the data of 184 diabetic patients over 40. The records showed PAD at ABI &lt; 0.9 and PWI &gt; 300. <bold>Results:</bold> The average age of 184 participants was 60.93 ± 9.68 years. By PWI and ABI, the prevalence of PAD was 25% and 20%, respectively. With an AUC of 0.805 (95% CI: 0.712–0.898, p = 0.002), ROC curve analysis showed that PWI outperformed ABI in terms of diagnostic performance (AUC: 0.663; 95% CI: 0.543–0.783, P &lt; 0.001). PWI showed a strong negative predictive value (93%) and good sensitivity (88.9%) at an ideal cutoff &gt; 156. ABI (&lt; 0.895), on the other hand, had low sensitivity (41.7%) but good specificity (95.9%). <bold>Conclusion:</bold> The pulse wave index performs better than the ankle-brachial index in terms of sensitivity and diagnostic efficacy when it comes to detecting peripheral arterial disease in high-risk diabetic patients. Future research should evaluate the long-term feasibility of employing PWI as the primary screening method to reduce PAD-related problems. </p>