Abstract

Application of the L-Dex Score for the Assessment of Bilateral Leg Edema

Kotaro Suehiro, Noriyasu Morikage, Takasuke Harada, Makoto Samura, Yuriko Takeuchi, Takahiro Mizoguchi, Kaori Nakamura, and Kimikazu Hamano. Lymphatic Research and Biology 2017

Background: We evaluated a modified L-Dex score by using the right arm as a reference (LDSrarm), to determine whether it could be used for the assessment of leg edema in place of the usual L-Dex score calculated by using the contralateral normal leg as a reference (LDScont).

Methods: Bioimpedance analysis was performed in the legs and right arms of 38 patients with unilateral leg edema and in 42 healthy volunteers by using a standard equipotential electrode arrangement.

Results: The impedance ratio in the right arms of patients (2.6–0.4) was lower than that in their contralateral normal legs (3.0–0.8, p<0.05), but it was similar to that in the legs (right: 2.4–0.7, left 2.5–0.8) of normal subjects. There was a significant correlation between LDScont and LDSrarm in legs with edema (right: r=0.80, left: r=0.93). No such correlation was found in the legs of normal subjects, but the mean–2 standard deviation of their LDSrarm ranged from -3 to 37, which was similar to LDSrarm values in legs with edema corresponding to the normal range of LDScont (-10 to 10), that is, from 1 to 34.

Conclusions: LDSrarm could be used as an alternative for LDScont in the assessment of leg edema.