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Diabetic major amputation in F ar N orth Q ueensland 1998–2008: What is the G ap for I ndigenous patients?
Author(s) -
O'Rourke Sharon,
Steffen Christina,
Raulli Alexandra,
Tulip Fiona
Publication year - 2013
Publication title -
australian journal of rural health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.48
H-Index - 49
eISSN - 1440-1584
pISSN - 1038-5282
DOI - 10.1111/ajr.12044
Subject(s) - amputation , indigenous , medicine , diabetic foot , diabetes mellitus , attendance , kidney disease , diabetic foot ulcer , gerontology , surgery , endocrinology , biology , ecology , economic growth , economics
Objective To examine demographic and clinical characteristics of diabetic patients undergoing diabetes‐related major amputation in F ar N orth Q ueensland 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.