Diabetic major amputation in Far North Queensland 1998-2008: what is the Gap for Indigenous patients?

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Authors: O’Rourke,S.;Steffen,C.;Raulli,A.;Tulip,F.

Publication: The Australian Journal of Rural Health

Year: 2013

Volume: 21

Issue: 5

Start Page: 268

ABSTRACT:

OBJECTIVE: To examine demographic and clinical characteristics of diabetic patients undergoing diabetes-related major amputation in Far North Queensland to identify those at risk.

DESIGN: A cohort was examined for differences between Indigenous and non-Indigenous groups in age, co-morbidities, indication for amputation and mortality. Attendance at the High Risk Foot Service was also reported.

SETTING: Far North Queensland.

PARTICIPANTS: individuals with major amputations between 1998 and 2008. MAIN OUTCOME MEASURES: Diabetes-related major amputations and mortality.

RESULTS: Of the 143 individuals who underwent major amputation during the study period, 52% were Indigenous. On average, Indigenous amputees were 14 years younger than non-Indigenous amputees. There were more female Indigenous amputees compared with Indigenous male amputees. Indigenous amputees were more likely to suffer from chronic kidney disease (P < 0.000) and reside in a remote community (P < 0.000). Sepsis as an indication for amputation was more frequent in Indigenous subjects (P = 0.019). There was no statistically significant difference in mortality related to the procedure between Indigenous and non-indigenous amputees.

CONCLUSION: Indigenous patients with renal disease living in remote communities are at higher risk of developing limb-threatening diabetic foot complications. Further improvements in self-care, diabetes management and foot-care are required to reduce major amputation rates, particularly for those residing in remote areas.

  • Listing ID: 4604
  • Author/s: O'Rourke,S.;Steffen,C.;Raulli,A.;Tulip,F.
  • Publication: The Australian Journal of Rural Health
  • Year: 2013
  • Volume: 21
  • Issue: 5
  • Start Page: 268
  • Article Keywords: Aged;Amputation/statistics & numerical data;Diabetes Complications/ethnology/surgery;Diabetic Foot/ethnology/surgery;Diabetic Nephropathies/complications/ethnology;Female;Foot/blood supply;Humans;Ischemia/surgery;Male;Middle Aged;Oceanic Ancestry Group;Queensland;Sepsis/complications/ethnology/surgery;Indigenous health;access issue;chronic disease;diabetes;remote