Validación de herramienta informática para el cálculo de linfedema en pacientes con afectación unilateral de extremidad superior

Abstract

Background Lymphedema following breast cancer surgery is a serious sequel that affects the quality of life of breast cancer patients. There are several methods to evaluate lymphedema. We have aimed to present and validate a computer tool that calculates the lymphedema volume based on perimeter measurements and to show the results of its reliability analysis. This tool design was developed without a randomized clinical trial with a control group. Material and methods A total of 29 patients were randomly selected from the Rehabilitation consultations of two centers in Madrid suffering unilateral lymphedema after mastectomy. Two rehabilitation doctors measured the arm perimeters of each patient using anatomic structures and with the frustum formula, using an Excel macro. Mean volume, standard deviation (SD) and variation coefficient (VC) were obtained for each measurement. Intra-and inter-rater reliability were calculated by estimation of the intra-class correlation coefficient (ICC) and its confidence interval (CI). Results Mean volume of affected arm was 3155.82 mL (877 SD) and for the healthy arm 2748.76 mL (667.1 SD). There were no significant differences in the SD and CV dispersion. Intra-rater ICC for the affected arm was 0.991 and 0.979, and for healthy arm 0.967 and 0.961 for each observer. Inter-rater ICC for the affected arm was 0.952 and for the healthy arm 0.976. Conclusions The «lymphedema calculator» is a reliable, reproducible, easy to use and low cost computer tool that helps the clinician to evaluate lymphedema volume as well as to objectify its distribution.