Key result
Mid-arm circumference moderately correlates with arm conicity index, though BMI shows a stronger association.
Why the study?
Arm dimensions outside recommended cuff sizes or trunco-conical arms can cause inaccurate BP measurements, motivating the evaluation of finger cuffs and the correlation of arm circumference, BMI, and weight with conicity index.
Does BMI, weight, or mid-arm circumference correlate with arm conicity index in Asian parturients?
Cohort (n=300)
No
Does BMI, weight, or mid-arm circumference correlate with arm conicity index in Asian parturients?
Effect estimate: r = 0.41 (95% CI 0.32-0.51)
p-value: p=<0.01
BMI correlates better with arm conicity index than mid-arm circumference or weight in Asian parturients, and standard finger cuffs may be a suitable alternative for blood pressure measurement, especially in obese patients who experience more issues with arm cuffs.
BMI may better inform cuff selection than mid-arm circumference in Asian parturients; leaves open whether finger cuffs improve accuracy in obese patients.
BACKGROUND: Accurate blood pressure (BP) measurement depends on appropriate cuff size and shape in relation to the arm. Arm dimensions outside the recommended range of cuff sizes or trunco-conical arms may result in inaccurate BP measurements. Measuring BP using finger cuffs is a potential solution. Arm cuff size is based on mid-arm circumference (MAC), and trunco-conicity is quantified by conicity index. We aimed to determine the correlation of MAC, body mass index (BMI), and weight with conicity index. METHODS: A prospective cohort study was conducted in the KK Women's and Children's Hospital where third trimester parturients scheduled for cesarean delivery were recruited after obtaining informed consent. Parturients were asked to rate their experience with time taken to obtain BP readings, cuff popping off during measurement, need to move the cuff from the upper arm to lower arm or leg, and need to change to a different cuff. Our primary outcome was the correlation between MAC and conicity index, calculated using Pearson's correlation. The correlation between BMI and weight with conicity index was also determined. RESULTS: We enrolled 300 parturients. Moderate correlation was found between left MAC and left conicity index (r = 0.41, 95% CI 0.32 to 0.51), and right MAC and right conicity index (r = 0.39, 95% CI 0.29 to 0.48). Weight (r = 0.35 to 0.39) and BMI (r = 0.41 to 0.43) correlated with conicity index in this study. MAC of 1 parturient fell outside the recommended range for arm cuffs, but all parturients fit into available finger cuffs. Obese parturients had increased problems with arm cuffs popping off and needing a change of cuff. CONCLUSIONS: BMI better correlated with conicity index compared to MAC or weight. Standard finger cuffs were suitable for all parturients studied and may be a suitable alternative. TRIAL REGISTRATION: Clinicaltrials.gov NCT04012151 . Registered 9 Jul 2019.
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Lim et al. (2020) conducted a cohort in Third trimester parturients scheduled for cesarean delivery (n=300). Arm and finger measurements was evaluated on Correlation between left mid-arm circumference (MAC) and left arm conicity index (r = 0.41, 95% CI 0.32-0.51, p=<0.01). Mid-arm circumference showed a moderate correlation with arm conicity index (r = 0.41) in Asian parturients, though body mass index correlated better with conicity index.
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