Pattern of major lower limb amputations at the Townsville Hospital: a retrospective review

Abstract

Background / Aims: North Queensland has a high prevalence of diabetes and vascular disease, particularly amongst the Indigenous population. Both are believed to contribute to lower limb amputations (LLAs), yet no local study has been conducted looking into possible contributing factors and clinical features leading to amputation. This study aimed to determine the prevalence of major LLAs and their associated risk factors at the Townsville Hospital between the years 2009 to 2012.\ud \ud Methods: All major amputations done under vascular surgery at Townsville Hospital from 1/1/2009 to 31/12/2012 were retrospectively audited. Non-parametric analysis and Chi-Square tests were performed using SPSS 20 to identify strongly associated variables with amputation.\ud \ud Results: A total of 83 subjects had major LLAs during the period of the study, with a male: female ratio of 1.8:1. Diabetes was identified as the likely cause of LLA in 53% of patients, with the ATSI subgroup comprising 34% of the cohort. The mean age of amputation was significantly lower amongst the ATSI population (49.95 + 4.0 years), compared with non-ATSI (69.27 + 1.7 years) [P < 0.001]. The ATSI population with diabetes had a higher risk of getting amputated (RR 4.97 [95% CI 1.2-20.5] P = 0.01). When comparing previous endovascular intervention prior to amputation amongst patients, 38.5% of ATSI patients had previous intervention compared with 73% in the non-ATSI [P = 0.03].\ud \ud Conclusion: Younger ATSI subjects with diabetes were at higher risk of LLA compared to their Caucasian counterparts, however further prospective studies are needed to confirm our findings

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