Hubungan Nilai Ankle-Brachial Index (ABI) dengan Derajat Luka Gangren pada Pasien Diabetes Melitus Tipe 2 di RS Siti Khodijah Sepanjang

Pendahuluan: Diabetes Melitus Tipe 2 memicu komplikasi vaskular dan luka gangren. Meskipun Ankle Brachial Index (ABI) lazim digunakan untuk mendeteksi perfusi perifer, objektivitasnya pada luka lanjut masih diperdebatkan. Penelitian ini bertujuan menganalisis hubungan nilai ABI dengan derajat luka gangren pada pasien Diabetes Melitus Tipe 2. Metode: Penelitian kuantitatif ini menggunakan desain analitik korelasi dengan pendekatan cross-sectional. Sebanyak 27 pasien dengan luka gangren dipilih menggunakan teknik accidental sampling. Nilai ABI diukur dengan sfigmomanometer digital, dan derajat luka dinilai dengan klasifikasi Wagner. Hubungan antar variabel diuji menggunakan korelasi Pearson (α = 0.05). Hasil: Hasil analisis menunjukkan tidak terdapat hubungan yang signifikan antara nilai ABI dengan derajat luka gangren (p = 0,433, r = -0,158). Meskipun memiliki luka dengan derajat Wagner yang tinggi, mayoritas pasien secara paradoks menunjukkan nilai ABI yang normal. Ketiadaan hubungan ini mengindikasikan adanya peningkatan nilai ABI semu (falsely elevated ABI) yang umumnya dipicu oleh kekakuan dinding arteri dan kalsifikasi tunika media akibat hiperglikemia kronis. Simpulan: Nilai ABI tidak berkaitan signifikan dengan derajat luka gangren pada sampel ini, kemungkinan karena keterbatasan ABI dalam mendeteksi gangguan mikrovaskular dan dampak kalsifikasi arteri. Tenaga kesehatan disarankan tidak mengandalkan ABI tunggal; asesmen klinis luka, pemeriksaan neuropati, evaluasi kontrol glikemik, dan pemeriksaan sirkulasi mikro perlu diintegrasikan untuk penatalaksanaan yang lebih akurat.

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Introduction: Type 2 diabetes mellitus leads to vascular complications and gangrene wounds. Although the Ankle-Brachial Index (ABI) is commonly used to assess peripheral perfusion, its reliability in advanced wounds remains controversial. This study aims to analyze the relationship between ABI values and the severity of gangrene wounds in patients with Type 2 Diabetes Mellitus. Methods: This quantitative study employed a correlational analytical design with a cross-sectional approach. A total of 27 patients with gangrene wounds were selected using accidental sampling. ABI values were measured with a digital sphygmomanometer, and wound severity was assessed using the Wagner classification. The correlation between variables was tested using Pearson’s correlation (α = 0.05). Results: The analysis revealed no significant association between ABI values and the severity of gangrene wounds (p = 0.433, r = −0.158). Despite having wounds with high Wagner severity, the majority of patients paradoxically exhibited normal ABI values. This lack of association indicated the presence of falsely elevated ABI values, which are generally triggered by arterial wall stiffness and tunica media calcification resulting from chronic hyperglycemia. Conclusion: ABI values were not significantly associated with the severity of gangrene in this sample, likely due to the limitations of the ABI in detecting microvascular disorders and the effects of arterial calcification. Healthcare professionals are advised not to rely solely on the ABI; clinical assessment of the wound, examination for neuropathy, evaluation of glycemic control, and assessment of microcirculation should be integrated for more accurate management.