Study: Can We Perform TcPO2 On The Foot To Predict One-Year Mortality?

Although physicians commonly use the ankle-brachial index (ABI), toe-brachial pressure (TBP) and transcutaneous oxygen pressure (TcPO₂) to diagnose peripheral artery disease (PAD), a recent study in Acta Diabetologica finds is that low TcPO₂ may actually be an independent marker of mortality.¹ 

The study, conducted by our colleagues in Lund, Sweden, involved 236 patients with diabetic foot ulcers and researchers utilized TcPO₂, ABI and TBP to assess the patients.¹ The study notes a TcPO₂ of less than 25 mmHg was associated with a higher one-year mortality in comparison with a TcPO₂ higher than 25 mmHg. The study adds that TBP and ABI did not significantly influence one-year mortality.

I think the real message from these data from our colleagues is not specifically that one device or another can predict mortality, but really that PAD in and of itself is a surrogate marker for cardiovascular disease. With the TcPO₂, we are in many cases able to see impaired tissue perfusion, which is likely happening in every vascular bed.

It’s that message that we need to communicate to our patients, namely that they may be at greater risk for morbidity and even mortality. I really think this is the discussion we have to be having with our patients, their families and the rest of the interdisciplinary team.

Reference

1. Fagher K, Katzman P, Löndahl M. Transcutaneous oxygen pressure as a predictor for short-term survival in patients with type 2 diabetes and foot ulcers: a comparison with ankle-brachial index and toe blood pressure. Acta Diabetol. 2018; epub April 30.