Disability and Quality of Life in Canadian Aboriginal and Non-Aboriginal Diabetic Lower-Extremity Amputees

Meatherall, Bonnie; Garrett, Mark; Kaufert, Joseph M.; Martin, Bruce D.; Fricke, Moni; Arneja, Amarjit S.; Duerksen, Frank; Koulack, Joshua; Fong, Hank; Simonsen, J. Neil; Nicolle, Lindsay E.; Trepman, Elly; Embil, John M.

doi:10.1016/j.apmr.2004.11.026

Cited by 29 publications

(33 citation statements)

References 24 publications

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“…The absence of links between diabetes duration and both physical functioning and role physical, could strengthen the role of the functional and mobility status as an independent factor influencing quality of life in diabetic subjects with LLA. However, in some studies impaired general functional status in diabetic people with LLA has been previously reported (Peters et al 2001;Meatherall et al 2005). Time elapsed after amputation, also appeared to decrease quality of life among the diabetic subjects with LLA, which may be linked to a more severe course of other complications to diabetes.…”

Section: Discussionmentioning

confidence: 96%

“…The symptom checklist, prevalence of symptoms (%) in 60 diabetic subjects with lower limb amputation. physical role (Price 2004;Meatherall et al 2005). Also the decreased mobility of amputees could have a negative effect on their psychological status, compared to the reference diabetic subjects (Carrington et al 1996).…”

Section: Discussionmentioning

confidence: 99%

“…The adverse impact of lower limb amputations (LLA) on health-related quality of life (HRQOL) in patients with diabetes mellitus has been shown in recent studies (Willrich et al 2005;Meatherall et al 2005). The quality of life of an individual is multifaceted, based on the patient's own perception of health.…”

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confidence: 99%

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Health Related Quality of Life and Sense of Coherence in Sudanese Diabetic Subjects with Lower Limb Amputation

Abdelgadir

Shebeika

Eltom³

et al. 2009

Tohoku J. Exp. Med.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Health Related Quality of Life and Sense of Coherence in Sudanese Diabetic Subjects with Lower Limb Amputation

Abdelgadir

Shebeika

Eltom³

et al. 2009

Tohoku J. Exp. Med.

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“…28 At the same time, Canadian aboriginal peoples have been found to have high rates of foot complications that places them at high risk of ulceration at a younger age, 29 studies have found aboriginal subjects to be younger than non-aboriginal counterparts at the time of diabetes diagnosis as well as first major LLA. 30 This has been attributed to poor health care seeking behavior and low level of foot care. 29 Another interesting finding in this report was the link between low hemoglobin, vitamin D and albumin levels in subjects with LLA.…”

Section: Discussionmentioning

confidence: 99%

Non-traumatic lower limb amputation in patients with end-stage renal failure on dialysis: an Australian perspective

et al. 2016

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Background: End-stage renal failure (ESRF) and dialysis have been identified as a risk factor for lower limb amputations (LLAs). High rate of ESRF amongst the Australian population has been reported, however till date no study has been published identifying magnitude and risk factors of LLA in subjects on renal dialysis. Objective: The study aims to document trends in the prevalence and identify risk factors of nontraumatic LLA in Australian patients on dialysis. Methods: A retrospective review of all patients (218) ] p¼ 0.01). 75% of the amputees had aboriginal heritage. We also identified higher HbA1c and CRP levels as well as low serum albumin, hemoglobin and vitamin D levels to have a strong association with LLAs (p < 0.05). Conclusion: There is high prevalence of LLAs amongst Australian indigenous patients with diabetes on dialysis in North Queensland. Other strongly associated risk factors include history of foot ulceration, foot deformity and peripheral neuropathy as well as high HbA1c levels and low serum albumin levels.

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“…Among patients with a DFI, ;5% will undergo a major amputation and 20-30% a 1 minor amputation, with the presence of peripheral arterial disease (PAD) greatly increasing amputation risk (4)(5)(6). Furthermore, lower-limb amputation is associated not only with significant morbidity and mortality but also with major psychosocial and financial consequences (7)(8)(9).…”

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confidence: 99%

Predictors of Lower-Extremity Amputation in Patients With an Infected Diabetic Foot Ulcer

et al. 2015

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OBJECTIVEInfection commonly complicates diabetic foot ulcers and is associated with a poor outcome. In a cohort of individuals with an infected diabetic foot ulcer, we aimed to determine independent predictors of lower-extremity amputation and the predictive value for amputation of the International Working Group on the Diabetic Foot (IWGDF) classification system and to develop a risk score for predicting amputation. RESEARCH DESIGN AND METHODSWe prospectively studied 575 patients with an infected diabetic foot ulcer presenting to 1 of 14 diabetic foot clinics in 10 European countries. RESULTSAmong these patients, 159 (28%) underwent an amputation. Independent risk factors for amputation were as follows: periwound edema, foul smell, (non)purulent exudate, deep ulcer, positive probe-to-bone test, pretibial edema, fever, and elevated C-reactive protein. Increasing IWGDF severity of infection also independently predicted amputation. We developed a risk score for any amputation and for amputations excluding the lesser toes (including the variables sex, pain on palpation, periwound edema, ulcer size, ulcer depth, and peripheral arterial disease) that predicted amputation better than the IWGDF system (area under the ROC curves 0.80, 0.78, and 0.67, respectively). CONCLUSIONSFor individuals with an infected diabetic foot ulcer, we identified independent predictors of amputation, validated the prognostic value of the IWGDF classification system, and developed a new risk score for amputation that can be readily used in daily clinical practice. Our risk score may have better prognostic accuracy than the IWGDF system, the only currently available system, but our findings need to be validated in other cohorts.Infection is a frequent complication of diabetic foot ulcers, with up to 58% of ulcers being infected at initial presentation at a diabetic foot clinic, increasing to 82% in patients hospitalized for a diabetic foot ulcer (1). These diabetic foot infections (DFIs) are associated with poor clinical outcomes for the patient and high costs for both the patient and the health care system (2). Patients with a DFI have a 50-fold increased risk of hospitalization and 150-fold increased risk of lowerextremity amputation compared with patients with diabetes and no foot infection (3). Among patients with a DFI, ;5% will undergo a major amputation and 20-30% a

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Disability and Quality of Life in Canadian Aboriginal and Non-Aboriginal Diabetic Lower-Extremity Amputees

Cited by 29 publications

References 24 publications

Health Related Quality of Life and Sense of Coherence in Sudanese Diabetic Subjects with Lower Limb Amputation

Health Related Quality of Life and Sense of Coherence in Sudanese Diabetic Subjects with Lower Limb Amputation

Non-traumatic lower limb amputation in patients with end-stage renal failure on dialysis: an Australian perspective

Predictors of Lower-Extremity Amputation in Patients With an Infected Diabetic Foot Ulcer

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