title: Reduced Incidence of Foot-Related Hospitalisation and Amputation amongst Persons with Diabetes in Queensland, Australia.
abstract: OBJECTIVE
  To determine trends in the incidence of foot-related hospitalisation and amputation amongst persons with diabetes in Queensland (Australia) between 2005 and 2010 that coincided with changes in state-wide ambulatory diabetic foot-related complication management.
  
  
  METHODS
  All data from cases admitted for the principal reason of diabetes foot-related hospitalisation or amputation in Queensland from 2005-2010 were obtained from the Queensland Hospital Admitted Patient Data Collection dataset. Incidence rates for foot-related hospitalisation (admissions, bed days used) and amputation (total, minor, major) cases amongst persons with diabetes were calculated per 1,000 person-years with diabetes (diabetes population) and per 100,000 person-years (general population). Age-sex standardised incidence and age-sex adjusted Poisson regression models were also calculated for the general population.
  
  
  RESULTS
  There were 4,443 amputations, 24,917 hospital admissions and 260,085 bed days used for diabetes foot-related complications in Queensland. Incidence per 1,000 person-years with diabetes decreased from 2005 to 2010: 43.0% for hospital admissions (36.6 to 20.9), 40.1% bed days (391 to 234), 40.0% total amputations (6.47 to 3.88), 45.0% major amputations (2.18 to 1.20), 37.5% minor amputations (4.29 to 2.68) (p < 0.01 respectively). Age-sex standardised incidence per 100,000 person-years in the general population also decreased from 2005 to 2010: 23.3% hospital admissions (105.1 to 80.6), 19.5% bed days (1,122 to 903), 19.3% total amputations (18.57 to 14.99), 26.4% major amputations (6.26 to 4.61), 15.7% minor amputations (12.32 to 10.38) (p < 0.01 respectively). The age-sex adjusted incidence rates per calendar year decreased in the general population (rate ratio (95% CI)); hospital admissions 0.949 (0.942-0.956), bed days 0.964 (0.962-0.966), total amputations 0.962 (0.946-0.979), major amputations 0.945 (0.917-0.974), minor amputations 0.970 (0.950-0.991) (p < 0.05 respectively).
  
  
  CONCLUSIONS
  There were significant reductions in the incidence of foot-related hospitalisation and amputation amongst persons with diabetes in the population of Queensland over a recent six-year period.
authors.affiliation: School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia; Allied Health Research Collaborative, Metro North Hospital & Health Service, Queensland Health, Brisbane, Queensland, Australia.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Lazzarini
authors.affiliation: Cairns Diabetes Centre, Queensland Health, Cairns, Queensland, Australia.
authors.forename: Sharon R
authors.initials: SR
authors.lastname: O'Rourke
authors.affiliation: Department of Diabetes & Endocrinology, Princess Alexandra Hospital, Brisbane, Queensland, Australia; School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Russell
authors.affiliation: Clinical Access and Redesign Unit, Queensland Health, Brisbane, Queensland, Australia.
authors.forename: Patrick H
authors.initials: PH
authors.lastname: Derhy
authors.affiliation: School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia; Diabetes Australia (Queensland), Brisbane, Queensland, Australia.
authors.forename: Maarten C
authors.initials: MC
authors.lastname: Kamp
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data*; D001315:Australia; D017719:Diabetic Foot / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged