Validity of a New Quantitative Evaluation Method that Uses the Depth of the Surface Imprint as an Indicator for Pitting Edema

Kogo, Haruki; Murata, Jun; Murata, Satoshi; Higashi, Toshio

doi:10.1371/journal.pone.0170810

Cited by 13 publications

(6 citation statements)

References 14 publications

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“…First, regarding the soft tissue thickness that was observed to have a negative correlation with PRT, soft tissue thickness is primarily an indicator of the degree of oedema. 16 Therefore, the results of this study suggest that the more severe the oedema, the shorter the PRT. Previous studies have reported a correlation between the visual extent of oedema and hypoalbuminaemia, 15 suggesting a high likelihood of relationships among soft tissue thickness, PRT and serum albumin levels.…”

Section: Discussionmentioning

confidence: 67%

Cross-sectional study investigating the relationship between pit recovery time and serum albumin levels in bilateral lower extremity pitting oedema

Ono,

Horibata

2024

BMJ Open

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ObjectivesIn this study, we re-evaluated the relationship between pit recovery time (PRT) and serum albumin levels and elucidated the factors influencing PRT.DesignCross-sectional study.SettingPatients who visited the outpatient department or were admitted to a small urban hospital in Japan.Participants135 adult Japanese patients with bilateral lower extremity pitting oedema.InterventionsPrimary and secondary outcome measures: this study assessed the correlation between PRT and serum albumin levels, calculated the predictive accuracy for identifying a group with low albumin levels when the PRT of the lower leg was <40 s, and identified variables that influence PRT.ResultsWe found no significant correlation between lower leg PRT and serum albumin levels. Furthermore, a PRT of <40 s was largely ineffective in predicting low albumin levels. Factors influencing PRT included the diagnosis of malnutrition oedema, examinations conducted during hospitalisation, diagnosis of cardiac oedema, use of diuretics, thickness of the lower limb soft tissue, serum creatinine level, estimated right ventricular systolic pressure (RVSP), age, serum albumin level, potassium level and blood urea nitrogen to serum creatinine ratio. Notable correlations with PRT were observed in relation to lower limb soft tissue thickness, age and estimated RVSP.ConclusionsGiven that the PRT is influenced by multiple factors, its correlation with serum albumin levels is weak. Thus, predicting hypoalbuminaemia based solely on PRT is inaccurate.

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Section: Discussionmentioning

confidence: 67%

Cross-sectional study investigating the relationship between pit recovery time and serum albumin levels in bilateral lower extremity pitting oedema

Ono,

Horibata

2024

BMJ Open

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“…A recent bioimpedance simulation study was published and concluded that future research is warranted to determine the feasibility of the method [ 3 ]. Another study tested the relationship between surface imprint and circumferential measurements as a potential evaluation method for edema but found there to be no significant relationship [ 6 ]. Measuring the circumference of the leg at a single point by using a device such as the Leg-O-Meter has been shown to be reproducible but is only helpful for estimating the volume of the lower limb at the location where the circumference was measured.…”

Section: Discussionmentioning

confidence: 99%

Developing an Edema Clinician-Reported Outcome Measure for Nephrotic Syndrome

Gipson¹,

Pal²,

Desmond³

et al. 2023

Glomerular Dis

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Introduction: Edema is a common manifestation of proteinuric kidney diseases, but there is no consensus approach for reliably evaluating edema. The objective of this study was to develop an edema clinician-reported outcome measure for use in patients with nephrotic syndrome. Methods: A literature review was conducted to assess existing clinician-rated measures of edema. Clinical experts were recruited from internal medicine, nephrology, and pediatric nephrology practices to participate in concept elicitation using semi-structured interviews and cognitive debriefing. Qualitative analysis methods were used to collate expert input and inform measurement development. In addition, training and assessment modules were developed using an iterative process that also utilized expert input and cognitive debriefing to ensure interrater reliability. Results: While several clinician-rated measures of edema have been proposed, our literature review did not identify any studies to support the reliability or validity of these measures. Fourteen clinician experts participated in the concept elicitation interviews, and twelve participated in cognitive debriefing. A clinician-reported outcome measure for edema was developed. The measure assesses edema severity in multiple individual body parts. An online training module and assessment tool were generated and refined using additional clinician input and investigative team expertise. Conclusion: The Edema ClinRO (V1) measure is developed specifically to measure edema in nephrotic syndrome. The tool assesses edema across multiple body parts, and it includes a training module to ensure standardized administration across raters. Future examination of this measure is ongoing to establish its reliability and validity.

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“…Patients treated with liposuction for LEL between September 1993 and May 2017 at the Department of Plastic and Reconstructive Surgery, Skåne University Hospital, Malmö, Sweden were included in this study. The inclusion criteria for the study were unilateral primary and secondary lymphedema with a 10% greater volume in the affected leg than in the contralateral leg; conservative treatment alone not leading to satisfactory reduction; edema with no or minimal pitting (<6-7 mm) [42][43][44] due to fat deposition; and a positive attitude toward continuous use of garments after liposuction. The exclusion criteria were bilateral lymphedema, active cancer, wounds, or ongoing infection.…”

Section: Patientsmentioning

confidence: 99%

Complete Reduction of Leg Lymphedema after Liposuction: A 5-Year Prospective Study in 67 Patients without Recurrence

Karlsson,

Hoffner,

Ohlin

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Lymphedema leads to adipose tissue deposition that cannot be removed using conservative methods. Previous studies have shown a complete reduction in excess volume in limbs with lymphedema when treated with liposuction and controlled compression therapy (CCT). We present the long-term outcomes of all patients treated with liposuction and CCT for lower extremity lymphedema (LEL) who were followed up for 5 years. Methods: Sixty-seven LEL patients underwent liposuction and CCT. Thirty-six patients had primary lymphedema and 31 patients had secondary lymphedema. The outcomes included excess leg volume over a follow-up period of 5 years. Any association between patient characteristics and treatment outcomes was analyzed. Results: The preoperative excess volume prior was 3515 mL [interquartile range (IQR): 2225–5455 mL], and the volume ratio to the unaffected leg was 1.35 (IQR: 1.25–1.53). One year after treatment, the excess volume decreased by 101% (IQR: 84–116). The decrease in excess volume continued during the 5-year follow-up, and at the end of the study, the excess volume had decreased by 115% (IQR: 98–124). No major complications were noted. Conclusions: Liposuction and CCT are safe and effective procedures for removing excess adipose tissue and normalizing the leg volume in patients with late-stage LEL. When no satisfactory results are obtained with conservative methods, such as complex decongestive therapy, and there is no or minimal pitting on limb examination, excess adipose tissue is present, and liposuction can be considered.

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Validity of a New Quantitative Evaluation Method that Uses the Depth of the Surface Imprint as an Indicator for Pitting Edema

Cited by 13 publications

References 14 publications

Cross-sectional study investigating the relationship between pit recovery time and serum albumin levels in bilateral lower extremity pitting oedema

Cross-sectional study investigating the relationship between pit recovery time and serum albumin levels in bilateral lower extremity pitting oedema

Developing an Edema Clinician-Reported Outcome Measure for Nephrotic Syndrome

Complete Reduction of Leg Lymphedema after Liposuction: A 5-Year Prospective Study in 67 Patients without Recurrence

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