Clark, Damien

Derhy, Patrick H

Lazzarini, Peter A

English

PubMed

Lazzarini Peter A

Clark Damien

Derhy Patrick H

Directory of Open Access Journals

Journal of Foot and Ankle Research

What are the major causes of lower limb amputations in a major Australian teaching hospital? The Queensland Diabetic Foot Innovation Project, 2006 – 2007

Peter A Lazzarini

Damien Clark

Patrick H Derhy

Springer - Publisher Connector

ORAL PRESENTATION Open Access
What are the major causes of lower limb
amputations in a major Australian teaching
hospital? The Queensland Diabetic Foot
Innovation Project, 2006 – 2007
Peter A Lazzarini1,2,3*, Damien Clark3,4, Patrick H Derhy5
From Australasian Podiatry Council Conference 2011
Melbourne, Australia. 26-29 April 2011
Background
Lower extremity amputation (LEA) results in significant
hospitalisation, rehabilitation, morbidity and mortality.
In 2004, 3,400 LEAs, with an average length of stay of
26 days, were performed in Australia for diabetic foot
complications alone. However, diabetic foot complica-
tions are commonly recognised as the most common
cause of “non-traumatic” LEA internationally. Unfortu-
nately, there seems to be a paucity of Australian data on
total numbers and causes of all LEAs. This retrospective
audit aimed to evaluate underlying primary indications
for LEA at a major Australian tertiary hospital.
Methods
Cases of LEA performed at the Princess Alexandra Hos-
pital (Brisbane, Australia) between July 2006 and June
2007 were identified through the relevant hospital dis-
charge dataset codes (n = 197). In all cases clinical
records were audited for indications of diabetes, trauma
and other major causes for LEA. Exclusion criteria
included records unable to be accessed during the
operation of the clinical audit and cases that were found
to have multiple possible major indicators of LEA.
Results
Eleven cases were excluded (9 inaccessible records and 2
multiple major indications). Cases included (n = 186)
accounted for 160 unique patients. Overall mean age at
LEA procedure was 67 years, 56% were first amputations,
54% were major amputations, and 9% died post-LEA in
the audit year. Cases with diabetes indicated accounted for
60% of all LEAs, had a mean age at 70 years, 45% were
first amputations, 50% were major amputations, and 7%
died post-LEA. Primary indications for LEAs (n = 186)
included: type 2 diabetes (53.2%), non-diabetes peripheral
vascular disease (18.3%), trauma or accident (8.1%), type 1
diabetes (7.0%), cancer or tumour (5.4%), orthopaedic
deformity (3.8%), and post-surgical emboli (2.2%).
Conclusions
Most literature indicates that diabetes is the largest
cause of “non-traumatic” LEAs. Our findings seemed to
indicate that diabetes was the largest cause or indication
of total LEAs. More statistical analysis between non-
diabetes and diabetes LEA populations in regards to
differences in age at LEA, major amputations, first
amputations and post-LEA death will be presented.
Author details
1Allied Health Research Collaborative, Metro North Health Service District,
Queensland Health, Brisbane, Australia. 2Department of Podiatry, Metro North
Health Service District, Queensland Health, Brisbane, Australia. 3School of
Public Health, Queensland University of Technology, Brisbane, Australia.
4Department of Podiatry, Metro South Health Service District, Queensland
Health, Brisbane, Australia. 5Centre for Healthcare Improvement, Queensland
Health, Brisbane, Australia.
Published: 20 May 2011
doi:10.1186/1757-1146-4-S1-O24
Cite this article as: Lazzarini et al.: What are the major causes of lower
limb amputations in a major Australian teaching hospital? The
Queensland Diabetic Foot Innovation Project, 2006 – 2007. Journal of
Foot and Ankle Research 2011 4(Suppl 1):O24.
* Correspondence: Peter_Lazzarini@health.qld.gov.au
1Allied Health Research Collaborative, Metro North Health Service District,
Queensland Health, Brisbane, Australia
Full list of author information is available at the end of the article
Lazzarini et al. Journal of Foot and Ankle Research 2011, 4(Suppl 1):O24
http://www.jfootankleres.com/content/4/S1/O24
JOURNAL OF FOOT
AND ANKLE RESEARCH
© 2011 Lazzarini et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in
any medium, provided the original work is properly cited.


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What are the major causes of lower limb amputations in a major Australian teaching hospital? The Queensland Diabetic Foot Innovation Project, 2006 – 2007

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