Convenient measurement of systolic pressure: the reliability and validity of manual radial pulse pressure measurement.

BACKGROUND

It is important to assess a patient's medical condition noninvasively, particularly in hospice care settings.

OBJECTIVE

The aim of this study was to investigate the reliability of manually measuring the radial pulse pressure and its validity for predicting the systolic blood pressure.

DESIGN

An observational study consisting of two phases: a reliability study and a validity study.

SETTING/SUBJECTS: Patients admitted to a palliative care unit.

MEASUREMENTS

To assess the interrater reliability, the radial pulse pressure was prospectively measured independently by a physician and nurse using a three-level assessment (impalpable, weak, and normal) in 43 patients admitted to a palliative care unit. To assess the validity, we analyzed a total of 156 patients, consisting of the prospectively collected patients and 113 patients retrospectively recruited. Radial pulse and systolic blood pressures were recorded on admission. We calculated the sensitivity and specificity of the radial pulse pressure to predict a systolic blood pressure of 90 mm Hg or more.

RESULTS

The κ coefficient of the physician and nurse was 0.788. The sensitivity and specificity to predict a systolic blood pressure of 90 mm Hg or more using the cutoff point of a normal versus weak/impalpable radial pulse pressure were 84% (95% confidence intervals, 77-89) and 82% (52-96), respectively.

CONCLUSIONS

Manually measuring the radial pulse pressure is reliable and can be used to indicate a systolic blood pressure of 90 mm Hg or more.