ArticleFoot & ankle orthopaedics2023
Risk Factors for Failure After Surgery in Patients With Diabetic Foot Syndrome.
Article in Foot & ankle orthopaedics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 7 citations in OpenAlex.
- Intralesional Epidermal Growth Factor and Its Association with Reamputation and Level-Up Amputation in Diabetic Foot Patients with Post-Amputation Flap Necrosis: Clinical Outcomes and Macrophage Dynamics.Medicina (Kaunas, Lithuania) · 2026Observational
- Clinical outcomes of tibial cortex transverse transport versus antibiotic-loaded bone cement for Wagner grade 3-4 diabetic foot ulcers: a real-world retrospective cohort study.Frontiers in endocrinology · 2026Article
- The Burden of Diabetic Gangrene: Prognostic Determinants of Limb Amputation from a Tertiary Center.Medicina (Kaunas, Lithuania) · 2025Observational
- Hyperbaric Oxygen Therapy as an Effective Adjunctive Treatment in the Reconstruction of Tissue Defects With Graft in Diabetic Foot Patients: A Retrospective Cohort Study.International wound journal · 2025Article
- The effect of the administration form of antibiotic therapy on the gut microbiome in patients with infected diabetic foot ulcers - DFIATIM trial.BMC microbiology · 2025Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: In the present study, we aimed to identify risk factors for failure (defined as reoperation within 60 days) after debridement or amputation at the lower extremity in patients with diabetic foot syndrome and to develop a model using the significant risk factors to predict the success rate at different levels of amputation. Methods: Between September 2012 and November 2016, we performed a prospective observational cohort study of 174 surgeries in 105 patients with diabetic foot syndrome. In all patients, debridement or the level of amputation, need for reoperation, time to reoperation, and potential risk factors were assessed. A cox regression analysis, dependent on the level of amputation, with the endpoint reoperation within 60 days defined as failure and a predictive model for the significant risk factors were conducted. Results: We identified the following 5 independent risk factors: More than 1 ulcer (hazard ratio [HR] 3.8), peripheral artery disease (PAD, HR 3.1), C-reactive protein >100 mg/L (HR 2.9), diabetic peripheral neuropathy (HR 2.9), and nonpalpable foot pulses (HR 2.7) are the 5 independent risk factors for failure, which were identified. Patients with no or 1 risk factor have a high success rate independent of the level of amputation. A patient with up to 2 risk factors undergoing debridement will achieve a success rate of <60%. However, a patient with 3 risk factors undergoing debridement will need further surgery in >80%. In patients with 4 risk factors a transmetatarsal amputation and in patients with 5 risk factors a lower leg amputation is needed for a success rate >50%. Conclusion: Reoperation for diabetic foot syndrome occurs in 1 of 4 patients. Risk factors include presence of more than 1 ulcer, PAD, CRP > 100, peripheral neuropathy, and nonpalpable foot pulses. The more risk factors are present, the lower the success rate at a certain level of amputation. Level of Evidence: Level II, prospective observational cohort study.
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