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Diabetic Amputation Audit by Dr. Andy Pettit: Insights and Recommendations in Bristol

This audit by Dr. Andy Pettit highlights findings of diabetic amputations in Bristol, including patient profiles, foot problems, levels of amputation, circulation status, and areas for improvement in care and prevention strategies.

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Diabetic Amputation Audit by Dr. Andy Pettit: Insights and Recommendations in Bristol

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  1. BRI diabetic amputation audit Dr Andy Pettit

  2. Introduction • Cases identified through through HAA coding 2002-3 • Patients initially from WGH or other Bristol hospitals were excluded

  3. 21 amputations • 14♂ • 7♀ • Age 71.6 (11.8) years Type 1: 3patients

  4. Preceding care • 10 managed in primary care • 5 managed in secondary care • 6 shared care • 14 had seen a chiropodist prior to amputation • Mean visits 10.2/year • 6 had <5 visits • 11 patients had Dr review of feet in year prior to amputation

  5. Nature of Foot Problems • 17 had an ulcer • 1 deformity requiring amputation • 12 ischaemic • 5 neuroischaemic • 3 neuropathic

  6. Levels of amputation • Toes 9 • BKA 4 • Through knee 4 • AKA 4

  7. Circulation • Angiogram 14/21 • Angio of ischaemic group 14/17 • Revascularisation 5 • Not suitable 11

  8. Previous Amputations • 4 minor • 1 major

  9. Cardiovascular risk reduction

  10. Possible improvements • Do we need to ask GPs to refer foot ulcers to the diabetic clinic • Or should referrals to podiatry also be seen in the medical clinic • Cardiovascular risk reduction strategies • Glycaemia control (how nihilistic can we be)

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