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Article << Previous     |     Next >>   Contents Vol 36(1)

Diabetes-related major lower limb amputation in Far North Queensland, 1998–2008

Sharon R. O’Rourke A C, Christina M. Steffen A, Alexandra Raulli B and Fiona J. Tulip B

A Diabetes Centre, Cairns Base Hospital, PO Box 902, Cairns, Qld 4870, Australia. Email: christina_steffen@health.qld.gov.au
B Tropical Regional Services – Cairns, Health Surveillance Unit, PO Box 1103, Cairns, Qld 4870, Australia. Email: alexandra_raulli@health.qld.gov.au; fiona_tulip@health.qld.gov.au
C Corresponding author. Email: sharon_o’rourke@health.qld.gov.au

Australian Health Review 36(1) 105-109 http://dx.doi.org/10.1071/AH10969
Submitted: 7 October 2010  Accepted: 20 June 2011   Published: 24 February 2012


 
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Abstract

Objective. To report on the accuracy of reports of diabetes-related major amputations, rates per 100 000 people and trends over the 10-year period from 1998–99 to 2007–08 in Far North Queensland.

Methods. Three data sources were cross-checked. Poisson regression was used to calculate the percentage change in trends in diabetes amputation hospitalisations over the period.

Results. There was a discrepancy of 6 (3.7%) in 161 cases over 10 years. The number of diabetes-related hospitalisations for major lower limb amputation did not show a significant trend during this period, with an annual percentage change of –0.32%, P = 0.915.

Conclusion. Amputation data in Far North Queensland were accurate. There was a modest reduction in the hospitalisation rate for major lower limb amputation over the 10-year period, demonstrating the need for improvements in the organisation of care.

What is known about the topic? Diabetic foot complications resulting in amputation are recognised internationally as a costly, major health problem. Limited data are available in the Australian context, especially for regional high risk populations.

What does this paper add? Accurate data on an Australian Institute of Health and Welfare recommended indicator, namely major amputations in people with diabetes. Confirmation of the accuracy of the data, enables benchmarking for future improvements.

What are the implications for practitioners? A focus on major amputations is a useful indicator of the quality and safety of care for people with diabetes.



References

[1]  Diabetes: Australian facts 2008. Canberra: Australian Institute of Health and Welfare; 2008. Available at http://www.aihw.gov.au/publications/cvd/daf08/daf08.pdf [verified 3 January 2012].

[2]  Tapp RJ, Shaw JE, de Courten MP, Dunstan DW, Welborn TA, Zimmet PZ. Foot complications in type 2 diabetes: an Australian population-based study. Diabet Med 2003; 20: 105–13.
CrossRef | CAS |

[3]  Towards national indicators of safety and quality in health care. Canberra: Australian Institute of Health and Welfare; 2009. Cat. no. HSE 75.

[4]  Rayman G, Krishnan ST, Baker NR, Wareham AM, Rayman A. Are we underestimating diabetes-related lower-extremity amputation rates? Results and benefits of the first prospective study. Diabetes Care 2004; 27: 1892–6.
CrossRef |

[5]  Payne C. Diabetes-related lower-limb amputations in Australia. MJA 2000; 173: 352–4.
| CAS |

[6]  2000–2006 Experimental Indigenous estimated resident populations by ages, sex and statistical local areas – Queensland as at 9 May 2009. Office of Economic and Statistical Research, Queensland Treasury, and Statistical and Library Services Centre, Queensland Health; 2009.

[7]  Steffen C, O’Rourke SR. Surgical management of diabetic foot complications: the Far North Queensland profile. Aust N Z J Surg 1998; 68: 258–60.
CrossRef | CAS |

[8]  SAS software. Version 4.22 of the SAS System for Unix. Cary, NC: SAS Institute Inc.; 2010.

[9]  Diabetes prevalence in Australia: an assessment of national data sources, October 2009. Canberra: Australian Institute of Health and Welfare; 2009. Available at http://www.aihw.gov.au/publications/cvd/cvd-46-10639/cvd-46-10639.pdf [verified 3 January 2012].

[10]  Colagiuri S, Colagiuri R, Ward J. National diabetes strategy and implementation plan. Canberra: Diabetes Australia; 1998.

[11]  Larsson J, Apelqvist J, Agardh C.-D, Stenstrom A. Decreasing incidence of major amputation in diabetic patients: a consequence of a multidisciplinary foot care team approach? Diabet Med 1995; 12: 770–6.
CrossRef | CAS |

[12]  van Houtum WH, Rauwerda JA, Ruwaard D, Schapper NC, Bakker K. Reduction in diabetes related lower extremity amputations in the Netherlands: 1991–2000. Diabetes Care 2004; 27: 1042–6.
CrossRef |

[13]  Queensland strategy for chronic disease 2005–2015. Brisbane: Queensland Health; 2005.

[14]  International consensus on the diabetic foot – practical guidelines. Amsterdam: International Working Group on the Diabetic Foot; 1999.

[15]  National evidence based guidelines for the management of type 2 diabetes mellitus (NHMRC endorsed) –part 6: identification & management of diabetic foot disease. Diabetes Australia; 2005. Available at http://www.nhmrc.gov.au/publications/synopses/_files/di12.pdf [verified 3 January 2012].

[16]  McDermott R, Tulip F, Schmidt B. Diabetes care in remote northern Australian Indigenous communities. Med J Aust 2004; 180: 512–6.

[17]  Lavery LA, Ashry HR, van Houtum W, Pugh JA, Harkless LB, Basu S. Variation in the incidence and proportion of diabetes related amputations in minorities. Diabetes Care 1996; 19: 48–52.
CrossRef | CAS |

[18]  The health of Queenslanders 2008: prevention of chronic disease. Brisbane: Queensland Health; 2008. Second Report of the Chief Health Officer Queensland.

[19]  Janigan DT, Hirsch DJ, Klassen GA, MacDonald AS. Calcified subcutaneous arterioles with infarcts of the subcutis and skin (‘calciphylaxis’) in chronic renal failure. Am J Kidney Dis 2000; 35: 588–97.
CrossRef | CAS |

[20]  Connelly J, Airey M, Chell S. Variation in clinical decision-making is a partial explanation for geographical variation in lower extremity amputation rates. Br J Surg 2001; 88: 529–35.
CrossRef | CAS |

[21]  Lawrence S, Wraight P, Campbell D, Colman P. Assessment and management of inpatients with acute diabetic foot complications: room for improvement. Intern Med J 2004; 34: 229–33.
CrossRef | CAS |

[22]  Wrobel JS, Charns MP, Diehr P, Robbins JM, Reiber GE, Bonacker KM, Haas LB, Pogach L. The relationship between provider coordination and diabetes-related foot outcomes. Diabetes Care 2003; 26: 3042–7.
CrossRef |

[23]  Trautner C, Haastert B, Mauckner P, Gatcke L, Giani G. Reduced incidence of lower limb amputations in the diabetic populations of a German city, 1990–2005. Diabetes Care 2007; 30: 2633–7.
CrossRef |

[24]  Apelqvist J, Ragnarson-Tennvall G, Larsson J, Persson U. Long-term costs for foot ulcers in diabetic patients in a multidisciplinary setting. Foot Ankle Int 1995; 16: 388–94.
| CAS |

[25]  Lavery LA, van Houtum WH, Armstrong DG. Institutionalization following diabetes-related lower extremity amputation. Am J Med 1997; 103: 383–8.
CrossRef | CAS |


   
 


    
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