Good Clinical Outcomes Following Minor Foot Amputations in People with Diabetes: A Retrospective Clinical Audit of Associated Factors

Clare LintonSchool of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Australia

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Angela SearleSchool of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Australia

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Vivienne ChuterSchool of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Australia

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Abstract

Background: The purpose of this retrospective audit was to compare patient based clinical outcomes to amputation healing outcomes twelve months after a minor foot amputation in people with diabetes.

Methods: Hospital admission and community outpatient data were extracted for all minor foot amputations in people with diabetes in 2017 in the Central Coast Local Health District.

Results: A total 85 minor foot amputations involving 74 people were identified. At the twelve-month follow-up 74% (n=56) of the minor foot amputations healed, 63% (n=41) of the participants achieved a good clinical outcome (healed, no more proximal amputations, or death within the 12 month follow up period), and the mortality rate was 18%. Poor clinical outcomes were associated with those aged greater than 60 (RR 5.75, 95% CI: 0.85 to 38.7, p=0.013), those undergoing a further surgical debridement procedure during their hospital stay (RR 2.42, 95% CI: 1.3 to 4.4, p=0.005) and those who did not attend CCLHD Podiatry clinics post-amputation (RR 2.3, 95% CI: 1.2 to 4.1, p=0.010).

Conclusions: To improve patient based clinical outcomes post-minor foot amputation, targeted follow-up in a high-risk foot clinic, and tailored discharge treatment plans for people aged over 60 or those undergoing a debridement procedure may be considered.

Corresponding author: Clare Linton, School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Australia, Central Coast Local Health District, BE130 Health Precinct, Brush Road, Ourimbah, NSW, Australia 2258. (E-mail: Clare.Linton@uon.edu.au)