期刊
AUSTRALIAN JOURNAL OF RURAL HEALTH
卷 21, 期 5, 页码 268-273出版社
WILEY
DOI: 10.1111/ajr.12044
关键词
access issue; chronic disease; diabetes; Indigenous health; remote
ObjectiveTo examine demographic and clinical characteristics of diabetic patients undergoing diabetes-related major amputation in Far North Queensland to identify those at risk. DesignA cohort was examined for differences between Indigenous and non-Indigenous groups in age, co-morbidities, indication for amputation and mortality. Attendance at the High Risk Foot Service was also reported. SettingFar North Queensland. Participantsindividuals with major amputations between 1998 and 2008. Main outcome measuresDiabetes-related major amputations and mortality. ResultsOf the 143 individuals who underwent major amputation during the study period, 52% were Indigenous. On average, Indigenous amputees were 14 years younger than non-Indigenous amputees. There were more female Indigenous amputees compared with Indigenous male amputees. Indigenous amputees were more likely to suffer from chronic kidney disease (P<0.000) and reside in a remote community (P<0.000). Sepsis as an indication for amputation was more frequent in Indigenous subjects (P=0.019). There was no statistically significant difference in mortality related to the procedure between Indigenous and non-indigenous amputees. ConclusionIndigenous patients with renal disease living in remote communities are at higher risk of developing limb-threatening diabetic foot complications. Further improvements in self-care, diabetes management and foot-care are required to reduce major amputation rates, particularly for those residing in remote areas.
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