Prevalence and risk factors of lower limb amputation amongst diabetic foot ulcer patients at the Townsville Hospital

Background/Aims: Diabetic foot ulcers (DFUs) are common amongst diabetic patients, occurring at a lifetime incidence of up to 15%. Lower limb amputation (LLA) is considered a frequent outcome, yet there is no local literature on the rates of LLA amongst DFUs patients in the diabetic population of North Queensland. The aim of this study is to find the prevalence of and risk factors for LLAs amongst DFU patients. Methods: A retrospective pilot study was conducted on patients attending The Townsville Hospital High Risk Foot Clinic (HRFC) between 2010- 2012. Non-parametric analysis and Chi-Square tests were performed using SPSS 20 to identify strongly associated variables with amputation. Results: A total of 106 subjects presented with a DFU at the HRFC during the study period, out of which (n= 43; 41%) underwent a LLA, with a male: female ratio of 1.7:1. The Indigenous subgroup comprised (n= 10; 23%) of the cohort. The mean age of amputation was 69.20 + 11.78 years, with no significant difference between the Indigenous and non-Indigenous cohorts. Diabetic retinopathy (OR 4.13 [95% CI 1.772-9.628] P = 0.001) and past history of coronary artery bypass graft surgery (CABG) (OR 4.0 [95% CI 1.094-14.624] P = 0.028) were factors strongly associated with amputation. Other variables that showed positive associations but fell short of statistical significance included Indigenous background, and history of hypertension, peripheral neuropathy and nephropathy. Conclusions: LLAs occurred in almost half of the DFU cohort at the HRFC, and were found to be closely linked with a history retinopathy and CABG surgery, however further prospective studies are required to confirm our findings.

Annals of the Australasian College of Tropical Medicine Inc

Annals of the Australasian College of Tropical Medicine

15

1448-4706

N/A

3

1