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Amputations in patients with diabetic foot ulcer: a retrospective study from a single centre in the Northern Territory of Australia
- Source :
- ANZ Journal of Surgery. 89:874-879
- Publication Year :
- 2019
- Publisher :
- Wiley, 2019.
-
Abstract
- Background Lower extremity amputations (LEAs) in diabetic patients are common in the indigenous population. There is no published data from the Northern Territory. Methods All patients with diabetic foot ulcer, presenting for the first time to the multi-disciplinary foot clinic at Royal Darwin Hospital, between January 2003 and June 2015, were included. These patients were followed until 2017, or death. LEA rates over the follow-up period and the risk factors were studied. Results Of the 513 included patients, 62.8% were males and 48.2% were indigenous. The majority (93.6%) had type 2 diabetes with median diabetes duration of 7.0 years (interquartile range 3-12). During the follow-up period of 5.8 years (interquartile range 3.1-9.8), a total of 435 LEAs (16.6% major; 34.7% minor) occurred in 263 patients (mean age 57.0 ± 11.8 years). In multivariate analysis, the following variables were associated with LEAs (adjusted odds ratio (95% confidence interval)): prior LEA (4.49 (1.69-11.9)); peripheral vascular disease (2.67 (1.27-5.59)); forefoot ulcer (7.72 (2.61-22.7)); Wagner grade 2 (3.71 (1.87-7.36)); and Wagner grade 3 (17.02 (3.77-76.72)). Indigenous patients were 1.8 times more likely to have LEAs than non-indigenous patients. Indigenous amputees were approximately 9 years younger than their non-indigenous counterparts. Conclusion Half of patients presenting with diabetic foot ulcer had LEA during follow-up. Prior LEAs, peripheral vascular disease, forefoot ulcers and higher Wagner grades were independent risk factors for LEA. Indigenous patients were at higher risk for LEAs and were younger at the time of amputation.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Population
Amputation, Surgical
03 medical and health sciences
0302 clinical medicine
Interquartile range
Internal medicine
Diabetes mellitus
Northern Territory
medicine
Humans
Indigenous Peoples
education
Aged
Retrospective Studies
education.field_of_study
business.industry
Retrospective cohort study
General Medicine
Odds ratio
Middle Aged
medicine.disease
Diabetic Foot
Diabetic foot ulcer
Amputation
030220 oncology & carcinogenesis
Female
030211 gastroenterology & hepatology
Surgery
business
Foot (unit)
Subjects
Details
- ISSN :
- 14452197 and 14451433
- Volume :
- 89
- Database :
- OpenAIRE
- Journal :
- ANZ Journal of Surgery
- Accession number :
- edsair.doi.dedup.....35c17df49d5bf738cf24f91f6abb7a13