title: Diabetic major amputation in Far North Queensland 1998-2008: what is the Gap for Indigenous patients?
abstract: OBJECTIVE
  To examine demographic and clinical characteristics of diabetic patients undergoing diabetes-related major amputation in Far North Queensland to identify those at risk.
  
  
  METHODS
  A 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.
  
  
  METHODS
  Far North Queensland.
  
  
  METHODS
  individuals with major amputations between 1998 and 2008.
  
  
  METHODS
  Diabetes-related major amputations and mortality.
  
  
  RESULTS
  Of 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.
  
  
  CONCLUSIONS
  Indigenous 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.
authors.affiliation: Diabetes Centre, Cairns and Hinterland HEalth and Hospital Services, Cairns, Queensland, Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: O'Rourke
authors.forename: Christina
authors.initials: C
authors.lastname: Steffen
authors.forename: Alexandra
authors.initials: A
authors.lastname: Raulli
authors.forename: Fiona
authors.initials: F
authors.lastname: Tulip
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D048909:Diabetes Complications / Q000208:ethnology / Q000601:surgery; D017719:Diabetic Foot / Q000208:ethnology* / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000150:complications / Q000208:ethnology; D005260:Female; D005528:Foot / Q000098:blood supply; D006801:Humans; D007511:Ischemia / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011793:Queensland; D018805:Sepsis / Q000150:complications / Q000208:ethnology / Q000601:surgery
keywords: Indigenous health; access issue; chronic disease; diabetes; remote