Evidence map›Paper›PMID 30171278›Full record

Observational studyDiabetologia2018

Amputation-free survival in 17,353 people at high risk for foot ulceration in diabetes: a national observational study.

Thenmalar Vadiveloo, William Jeffcoate, Peter T Donnan, Helen C Colhoun, Stuart McGurnaghan, Sarah Wild, Rory McCrimmon, Graham P Leese, Scottish Diabetes Research Network Epidemiology Group

Open access · hybridAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Diabetologia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 4 pooled it
5.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 4 syntheses or guidelines pooled it, 90 citations in OpenAlex.

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  5. Banting memorial lecture 2025: Aligning clinical practice, policy and research.Diabetic medicine : a journal of the British Diabetic Association · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Thenmalar VadivelooDivision of Population Health Sciences, Medical Research Institute, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF, UK. t.vadiveloo@dundee.ac.uk.
William JeffcoateNottingham University Hospitals Trust, Nottingham, UK.
Peter T DonnanDivision of Population Health Sciences, Medical Research Institute, University of Dundee, The Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF, UK.
Helen C ColhounInstitute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK.
Stuart McGurnaghanInstitute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK.
Sarah WildUsher Institute for Public Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
Rory McCrimmonDivision of Molecular and Clinical Medicine, University of Dundee, Dundee, UK.
Graham P LeeseDivision of Molecular and Clinical Medicine, University of Dundee, Dundee, UK.
Scottish Diabetes Research Network Epidemiology Group
University of Dundee · GBUniversity of Edinburgh · GBMRC Institute of Genetics and Molecular Medicine · GBNottingham University Hospitals NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aims/hypothesisOur aim was to investigate amputation-free survival in people at high risk for foot ulceration in diabetes ('high-risk foot'), and to compare different subcategories of high-risk foot.

methodsOverall, 17,353 people with diabetes and high-risk foot from January 2008 to December 2011 were identified from the Scotland-wide diabetes register (Scottish Care Information-Diabetes: N = 247,278). Participants were followed-up for up to 2 years from baseline and were categorised into three groups: (1) those with no previous ulcer, (2) those with an active ulcer or (3) those with a healed previous ulcer. Participants with prior minor or major amputation were excluded. Accelerated failure time models were used to compare amputation-free survival up to 2 years between the three exposure groups.

resultsThe 2 year amputation-free survival rate in all people with diabetes with high-risk foot was 84.5%. In this study group, 270 people (10.0%) had an amputation and 2424 (90.0%) died during the 2 year follow-up period. People who had active and healed previous ulcers at baseline had significantly lower 2 year amputation-free survival compared with those who had no previous ulcer (both p < 0.0001). The percentage of people who died within 2 years for those with healed ulcer, active ulcer or no baseline ulcer was 22.8%, 16% and 12.1%, respectively. CONCLUSIONS/

interpretationIn people judged to be at high risk of foot ulceration, the risk of death was up to nine times the risk of amputation. Death rates were higher for people with diabetes who had healed ulcers than for those with active ulcers. However, people with active ulcers had the highest risk of amputation.

Indexed as

Amputation, SurgicalAgedAged, 80 and overDiabetic FootFemaleFoot UlcerHumansMaleMiddle AgedAmputationDiabetesFootMortalityUlcer

Identifiers

PMID30171278
PMCPMC6223842
OpenAlexW2888972819

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.