Diabetes: the leading condition associated with lower limb amputations in a major Australian teaching hospital? — ASN Events
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Diabetes: the leading condition associated with lower limb amputations in a major Australian teaching hospital? (#13)

Peter A Lazzarini 1 2 , Sharon R O'Rourke 3 , Anthony W Russell 4 5 , Damien Clark 2 , Suzanne S Kuys 1 6
  1. Allied Health Research Collaborative, Metro North Hospital & Health Service, Brisbane, Qld, Australia
  2. School of Clinical Sciences, Queensland University of Technology, Brisbane, Qld, Australia
  3. Musculoskeletal Research Program, Griffith University, Gold Coast, Qld, Australia
  4. Department of Diabetes & Endocrinology, Princess Alexandra Hospital, Queensland Health, Brisbane, Qld, Australia
  5. School of Medicine, University of Queensland, Brisbane, Qld, Australia
  6. Diamantina Institute, The University of Queensland, Brisbane, Qld, Australia

Background

Lower extremity amputation results in significant global morbidity and mortality.  Australia appears to have a paucity of studies investigating amputation.   The primary aim of this retrospective study was to investigate key conditions associated with amputations in an Australian population.  Secondary objectives were to determine the influence of age and sex on amputations, and the reliability of hospital coded amputations.

Methods:

Lower extremity amputation cases performed at the Princess Alexandra Hospital between July 2006 and June 2007 were identified through the relevant hospital discharge dataset (n = 197).  All eligible clinical records were interrogated for age, sex, key condition associated with amputation, amputation site, first ever amputation status and the accuracy of the original hospital coding.  Chi-squared, t-tests, ANOVA and post hoc tests were used to determine differences between groups.  Kappa statistics were used to measure coding reliability.

Results:

One hundred and eighty-six cases were eligible and audited.  Overall 69% were male, 56% were first amputations, 54% were major amputations, and mean age was 62 ± 16 years.  Key conditions associated included type 2 diabetes (53%), peripheral arterial disease (non-diabetes) (18%), trauma (8%), type 1 diabetes (7%) and malignant tumours (5%).  Differences in ages at amputation were associated with trauma 36 ± 10 years, type 1 diabetes 52 ± 12 years and type 2 diabetes 67 ± 10 years (p < 0.01).   Reliability of original hospital coding was high with all Kappa values over 0.8.

Conclusions:

This study, appears to be the first in over 20 years to report on all levels of lower extremity amputations in Australia, found that people undergoing amputation are more likely to be older, male and have diabetes.  It is recommended that large prospective studies are implemented and national amputation rates are established to address the large preventable burden of amputation in Australia.