{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T02:21:26Z","timestamp":1783736486581,"version":"3.55.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5","funder":[{"name":"Department of Veterans Affairs VA Merit Review","award":["I01 BX004677-01"],"award-info":[{"award-number":["I01 BX004677-01"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Diabetic foot infections constitute 20% of hospital admissions and are the underlying cause of 80% of amputations annually. Staging magnetic resonance imaging (MRI) may decrease reamputation rates in diabetic foot osteomyelitis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective chart review was conducted to analyze the risk of reamputation in patients with diabetic foot osteomyelitis hospitalized between 2005 and 2022. MRI-guided therapy and proximal surgical margin pathologic evidence of osteomyelitis were compared. The primary outcome was the rate of reamputation up to 365 days.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Enrollment consisted of 386 veterans with a diabetic foot infection complicated by osteomyelitis that required initial amputation, of which 110 patients required reamputation. MRI-guided therapy occurred in 89 of these patients. Preoperative MRI and subsequent MRI-guided therapy were associated with a significant decrease in the chance of reamputation for up to a year after the initial amputation as compared with non\u2013MRI-guided therapy (14\/89 [15.7%] vs 96\/297 [32.3%], respectively; P = .0024, \u03c72 test). A Cox proportional hazard model demonstrated that MRI-guided therapy had a significant association with decreasing the relative risk of reamputation (hazard ratio, 0.47; 95% CI, .26\u2013.83; P = .0098). Initial proximal margin pathologic findings consistent with osteomyelitis were not associated with the risk of reamputation (hazard ratio, 1.25; 95% CI, .81\u20131.93; P = .31).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These findings support that incorporating preamputation MRI and MRI-guided therapy into the diagnostic and treatment approach for diabetic foot osteomyelitis may reduce the risk for subsequent amputations over 1 year.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf189","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T12:01:18Z","timestamp":1745841678000},"source":"Crossref","is-referenced-by-count":4,"title":["Association of Magnetic Resonance Imaging\u2013Guided Management With Reamputation Rates in Diabetic Foot Osteomyelitis"],"prefix":"10.1093","volume":"12","author":[{"given":"Kari A","family":"Mergenhagen","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Veterans Affairs Western New York Healthcare System , Buffalo, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiachen","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Veterans Affairs Western New York Healthcare System , Buffalo, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur K","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Veterans Affairs Western New York Healthcare System , Buffalo, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandre C","family":"Charles","sequence":"additional","affiliation":[{"name":"Department of Podiatry, Veterans Affairs Western New York Healthcare System , Buffalo, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany A","family":"Wattengel","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Veterans Affairs Western New York Healthcare System , Buffalo, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4145-7324","authenticated-orcid":false,"given":"Ashley L","family":"O\u2019Leary","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Veterans Affairs Western New York Healthcare System , Buffalo, New York ,","place":["USA"]},{"name":"Department of Pharmacy Practice, D\u2019Youville School of Pharmacy , Buffalo, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew G","family":"Puckett","sequence":"additional","affiliation":[{"name":"Department of Podiatry, Veterans Affairs Western New York Healthcare System , Buffalo, New York 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,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4566-7442","authenticated-orcid":false,"given":"Thomas A","family":"Russo","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Veterans Affairs Western New York Healthcare System , Buffalo, New York ,","place":["USA"]},{"name":"Division of Infectious Diseases, Department of Medicine, University at Buffalo, State University of New York , Buffalo, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"2025052602114113700_ofaf189-B1","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1001\/jama.2015.10029","article-title":"Prevalence of and trends in diabetes among adults in the United States, 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