Predicting Major Amputation Rates in Diabetic Hindfoot Ulcers With Critical Infection and Ischemia: A Risk-Factor-Based Model

Background

Diabetic hindfoot ulcers pose a substantially greater risk of progressing to major amputation than forefoot or midfoot ulcers. Patients with these ulcers often experience severe psychological distress at the prospect of major limb loss. Consequently, patients, their families, and healthcare professionals prioritize understanding the actual risk of major amputation based on the patient's current clinical status. However, practical tools addressing this critical and common concern remain limited. In a previous preliminary study, we proposed a model for predicting major amputation rates in diabetic hindfoot ulcers. Nonetheless, that model, which relied solely on ischemia and infection, demonstrated limited accuracy. The present study aimed to refine the prediction of major amputation in diabetic hindfoot ulcers by 1) identifying additional risk factors and 2) evaluating amputation rates according to these factors.