HUBUNGAN ANKLE BRACHIAL INDEX DENGAN KEPARAHAN ULKUS PADA PENDERITA KAKI DIABETIK

Abstract

Abstract: This study aimed to determine the relationship between ankle brachial index (ABI) and the severity of ulcer using Wagner classification among patients with diabetic foot in Prof. Dr. R. D. Kandou Hospital Manado. This was an observational study with a cross-sectional design conducted at the Department of Surgery and Department of Internal Medicine of Prof. Dr. R.D. Kandou Manado Hospital from January to June 2015. The results showed that there were 38 patients with diabetic foot ulcers. The highest proportion was the group of patients with Wagner grade 4 (10 patients - 26.3%), followed by grade 1 (9 patients - 23.7%), grade 2 and 3 (each of 8 patients - 21.05%), and grade 5 (3 patients - 7.9%). There were 22 patients (57.9%) with normal ABI values, followed by moderate ischemia in 8 patients (21.1%), mild ischemia in 7 patients (18.4%), and only 1 patient (2.6%) with severe vascular obstruction. The Spearman test showed a P value of 0.008 which meant that there was a significant correlation between ABI and the severity of ulcer. The lower the ABI value, the more severe the ulcer of diabetic foot cases Conclusion: ABI value had a significant relationship with the severity of ulcers of diabetic foot patients.
Keywords: ABI, diabetic foot

Abstrak: Penelitian ini bertujuan untuk mengetahui hubungan Ankle Brachial Index (ABI) dengan derajat keparahan ulkus pada penderita dengan kaki diabetik yang dirawat di RSUP Prof. Dr. R. D. Kandou Manado. Penelitian berupa studi observasional dengan desain potong lintang yang dilakukan di Bagian Bedah dan Bagian Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado selama periode Januari sampai Juni 2015. Hasil penelitian mendapatkan 38 penderita kaki diabetik dengan proporsi terbanyak yaitu penderita dengan ulkus Wagner grade 4 sebanyak 10 pasien (26,3%), diikuti grade 1 sebanyak 9 pasien (23,7%), grade 2 dan 3 masing-masing sebanyak 8 pasien (21,05%), dan terakhir ulkus Wagner grade 5 sebanyak 3 pasien (7,9%). Nilai ABI normal didapatkan paling banyak yaitu pada 22 pasien (57,9%), diikuti oleh obstruksi vaskular sedang sebanyak 8 pasien (21,1%) dan iskemi ringan sebanyak 7 pasien (18,4%), dan hanya 1 pasien (2,6%) dengan obstruksi vaskular berat. Hubungan ABI dan keparahan ulkus diuji dengan analisis koefisien koreksi Spearman dan mendapatkan nilai P = 0,008 yang menunjukkan makin rendah nilai ABI maka nilai keparahan ulkus semakin besar. Simpulan: Nilai ABI memiliki hubungan bermakna dengan keparahan ulkus penderita kaki diabetik.
Kata kunci: ABI, kaki diabetik