| Chang et al., (13) 2018 | US | 4 | 651/92 279 | 45.7/54.3 | 71.9 ± 11.9 |
Incidence of major amputation within 1 yr after diagnosis of DFU was higher for Native American patients than White patients (4.1% v. 1.0%, p < 0.001) In multivariable analysis, being Native American was associated with increased risk of major amputation compared to being White (HR 2.42, 95% CI 1.62–3.62)
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| Commons et al., (22) 2015 | Australia | 1 | 114/63 | 59.9/40.1 | 54.4 (95% CI 28.8–80.1) |
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| Jia et al., (23) 2017 | Australia | 1 | 66/441 | 68/32 | 62.9 ± 12.8 |
Independent risk factors for infection: ulcers healed between 3 and 12 mo (OR 2.3 [95% CI 1.6–3.3]), deep ulcers (OR 2.2 [95% CI 1.2–3.9]), peripheral neuropathy (OR 1.8 [95% CI 1.1–2.9]), previous foot ulcers (OR 1.7 [95% CI 1.2–2.4]), foot deformity (OR 1.4 [95% CI 1.0–2.0]), female gender (OR 1.5 [95% CI 1.1–2.1]) and age (OR 0.98 [95% CI 0.97–0.99]) No association found between infection and Indigenous background
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| Rodrigues et al., (24) 2016 | Australia | 3 | 23/106 | 62.8/37.2 | 63.43 ± 14.07 (CI 60.98–65.89) |
Indigenous group had higher amputation rate than non-Indigenous group (56.5% v. 29.2%) Mean age at amputation was similar in Indigenous (62 [SD 12.5] yr [95% CI 55.09–70.14 yr]) and non-Indigenous (62.0 [SD 11.5] yr [95% CI 57.81–66.25 yr]) groups
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| Rose et al., (25) 2008 | Canada | 1 | 101/224 | 63/37 | 59 ± 14 (Aboriginal 55 ± 13, non-Aboriginal 61 ± 14) |
Aboriginal patients had higher rate of any amputation than non-Aboriginal patients (24% v. 15%), but frequency of major amputation (defined in this study as amputation proximal to toes) was not influenced by ethnicity Aboriginal patients had shorter average time from initial clinic visit to major lower-extremity amputation than non-Aboriginal patients (50 [SD 64] wk v. 62 [SD 56] wk, p < 0.01) Living in rural or reserve community was correlated with shorter average time from initial clinic visit to major lower-extremity amputation than living in urban community (45 [SD 56] wk v. 66 [SD 61] wk, p < 0.002) Aboriginal ethnicity was not associated with poorer clinical outcome when nonurban residence was controlled for Earlier major lower-extremity amputation was significantly associated with nonurban residence, Aboriginal ethnicity and arterial insufficiency on univariate analysis; however, when nonurban residence was controlled for, Aboriginal ethnicity was not associated with earlier amputation
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| Tan et al., (26) 2019 | US | 12 | 1654/149 070 | 66.6/33.4 | 59.2 ± 13.7 (Aboriginal 54.4 ± 13.3, White 60.7 ± 13.4) |
Native American patients had increasing trend of major amputation over study period Native American patients had significantly higher major amputation rates than White patients (5.4% v. 7.1%, p < 0.001) and higher risk of major amputation (OR 1.47 [95% CI 1.2–1.8]) Native American patients had lowest rates of open bypass (0.9%) and endovascular revascularization (5.0%) of all ethnic groups studied (p < 0.001)
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