ArticlePloS one2026
Risk factors associated with diabetic foot amputation: A retrospective study from a tertiary hospital in Central Malaysia.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Diabetes mellitus continues to escalate as a major global health crisis, with diabetic foot infection (DFI) remaining one of the most serious and preventable complications. Despite advances in multidisciplinary care, amputation rates remain high, particularly in low- and middle-income settings. This retrospective study identifies key predictors associated with the level of amputation; major (above the knee) versus minor (at or below the knee) among patients with DFI following surgical decision-making. Electronic medical records of 434 patients admitted with DFI to a tertiary care hospital in Central Malaysia between January 2010 and December 2019 were analysed. Minor amputations accounted for 70.7% of cases, while major amputations comprised the remainder. Most patients (63.8%) presented with advanced disease, with Wagner grade 4 being the most prevalent (40.3%). Binary logistic regression analysis was employed to determine independent predictors of amputation level. Increasing age (OR = 1.06, p = .013) and higher Wagner classification (OR = 15.16, p < .001) emerged as significant independent predictors of major amputation. These results highlight the need for timely intervention and aggressive limb-salvage strategies in high-risk groups.
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