Limb amputation in Indigenous Australians on renal dialysis: the Townsville Hospital experience

Gilhotra, Rajit A., Rodrigues, Beverly T., Vangaveti, Venkat N., Kan, George, Sangla, Kunwarjit S., and Malabu, Usman H. (2014) Limb amputation in Indigenous Australians on renal dialysis: the Townsville Hospital experience. Annals of the Australasian College of Tropical Medicine, 15 (3). p. 60.

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Abstract

Background/Aims: North Queensland has high prevalence of diabetes, vascular disease and end stage renal failure (ESRF) requiring renal dialysis, particularly amongst the Indigenous Australians. Recent reports have identified dialysis as a risk factor for lower limb amputations but no study has been done to explore the differences in Indigenous Australians and the general population. The aim of this study was to document differences between Indigenous Australians and the general population for risk factor of non-traumatic limb amputation in North Queensland.

Methods: All patients currently attending The Townsville dialysis centre were included in this study. Odds ratio and χ2 tests were performed to identify variables most strongly associated with amputation.

Results: We had a total of 219 patients (114 Indigenous Australians) attending the service. We identified an overall prevalence of limb amputation of 13.7% in patients on renal dialysis (19.3% amongst Indigenous Australians on renal dialysis). Indigenous Australians were found to have a higher susceptibility to amputations (RR1.58 [1.27-1.98] p=0.005). The major risk factors of amputations in the overall cohort were history of ulceration (OR 81 [18-360.44] p<0.001) and presence of diabetes (OR 41 [2.5-682.6] p=0.009).

Conclusion: Indigenous Australians with ESRF on dialysis who have a past history of ulceration and have diabetes mellitus are at higher risk of having amputations compared with non-Indigenous Australians. Primary prevention of diabetes in the sub-population may help in reducing the limb loss. Further prospective studies on a larger population are needed to confirm our findings.

Item ID: 35825
Item Type: Article (Abstract)
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ISSN: 1448-4706
Date Deposited: 29 Oct 2014 04:36
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110306 Endocrinology @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920104 Diabetes @ 50%
92 HEALTH > 9203 Indigenous Health > 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes @ 50%
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