What are the key conditions associated with lower limb amputations in a major Australian teaching hospital?

Lazzarini, Peter A., O'Rourke, Sharon R., Russell, Anthony W., Clark, Damien and Kuys, Suzanne (2012) What are the key conditions associated with lower limb amputations in a major Australian teaching hospital?. Journal of Foot and Ankle Research, 5 1: 12.1-12.9. doi:10.1186/1757-1146-5-12


Author Lazzarini, Peter A.
O'Rourke, Sharon R.
Russell, Anthony W.
Clark, Damien
Kuys, Suzanne
Total Author Count Override 5
Title What are the key conditions associated with lower limb amputations in a major Australian teaching hospital?
Journal name Journal of Foot and Ankle Research   Check publisher's open access policy
ISSN 1757-1146
Publication date 2012-05
Sub-type Article (original research)
DOI 10.1186/1757-1146-5-12
Open Access Status DOI
Volume 5
Issue 1
Start page 12.1
End page 12.9
Total pages 9
Place of publication London, United Kingdom
Publisher BioMed Central
Collection year 2013
Language eng
Formatted abstract
Background: Lower extremity amputation results in significant global morbidity and mortality. Australia appears to have a paucity of studies investigating lower extremity amputation. The primary aim of this retrospective study was to investigate key conditions associated with lower extremity amputations in an Australian population. Secondary objectives were to determine the influence of age and sex on lower extremity amputations, and the reliability of hospital coded amputations.
Methods: Lower extremity amputation cases performed at the Princess Alexandra Hospital (Brisbane, Australia) 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. Exclusion criteria included records unavailable for audit and cases where the key condition was unable to be determined. Chi-squared, t-tests, ANOVA and post hoc tests were used to determine differences between groups. Kappa statistics were used to measure reliability between coded and audited amputations. A minimum significance level of p < 0.05 was used throughout.
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 (nondiabetes) (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 Kappa values over 0.8 for all variables.
Conclusions: This study, 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 lower extremity amputation rates are established to address the large preventable burden of lower extremity amputation in Australia.
Keyword Amputation
Foot
Diabetes
Peripheral arterial disease
Trauma
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article # 12

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Medicine Publications
 
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Created: Mon, 24 Sep 2012, 17:21:48 EST by Dr Anthony Russell on behalf of Medicine - Princess Alexandra Hospital