{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T02:18:41Z","timestamp":1793499521413,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,11,24]],"date-time":"2021-11-24T00:00:00Z","timestamp":1637712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study aimed to explore the clinical characteristic and outcomes of inpatients with diabetic foot ulceration (DFU) in 2019 (prelockdown) and 2020 (postlockdown) due to the COVID\u201019 pandemic, at an emergency medical service unit. Prediction models for mortality and amputation were developed to describe the risk factors using a machine learning\u2010based approach. Hospitalized DFU patients (N\u00a0=\u00a023) were recruited after the lockdown in 2020 and matched with corresponding inpatients (N\u00a0=\u00a023) before lockdown in 2019. Six widely used machine learning models were built and internally validated using 3\u2010fold cross\u2010validation to predict the risk of amputation and death in DFU inpatients under the COVID\u201019 pandemic. Previous DF ulcers, prehospital delay, and mortality were significantly higher in 2020 compared to 2019. Diabetic foot patients in 2020 had higher hs\u2010CRP levels (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.037) but lower hemoglobin levels (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.017). The extreme gradient boosting (XGBoost) performed best in all models for predicting amputation and mortality with the highest area under the curve (0.86 and 0.94), accuracy (0.80 and 0.90), sensitivity (0.67 and 1.00), and negative predictive value (0.86 and 1.00). A long delay in admission and a higher risk of mortality was observed in patients with DFU who attended the emergency center during the COVID\u201019 post lockdown. The XGBoost model can provide evidence\u2010based risk information for patients with DFU regarding their amputation and mortality. The prediction models would benefit DFU patients during the COVID\u201019 pandemic.<\/jats:p>","DOI":"10.1111\/iwj.13723","type":"journal-article","created":{"date-parts":[[2021,11,26]],"date-time":"2021-11-26T08:34:00Z","timestamp":1637915640000},"page":"1289-1297","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["The amputation and mortality of inpatients with diabetic foot ulceration in the <scp>COVID<\/scp>\u201019 pandemic and <scp>postpandemic<\/scp> era: A machine learning study"],"prefix":"10.1111","volume":"19","author":[{"given":"Chenzhen","family":"Du","sequence":"first","affiliation":[{"name":"Department of Endocrinology, School of Medicine, Bioengineering College, Chongqing Emergency Medical Center, Chongqing University Central Hospital Chongqing University  Chongqing China"},{"name":"Bioengineering College, Key Laboratory for Biorheological Science and Technology of Ministry of Education Chongqing University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuyao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, School of Medicine, Bioengineering College, Chongqing Emergency Medical Center, Chongqing University Central Hospital Chongqing University  Chongqing China"},{"name":"Bioengineering College, Key Laboratory for Biorheological Science and Technology of Ministry of Education Chongqing University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puguang","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, School of Medicine, Bioengineering College, Chongqing Emergency Medical Center, Chongqing University Central Hospital Chongqing University  Chongqing China"},{"name":"Bioengineering College, Key Laboratory for Biorheological Science and Technology of Ministry of Education Chongqing University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, School of Medicine, Bioengineering College, Chongqing Emergency Medical Center, Chongqing University Central Hospital Chongqing University  Chongqing China"},{"name":"Bioengineering College, Key Laboratory for Biorheological Science and Technology of Ministry of Education Chongqing University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Deng","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, School of Medicine, Bioengineering College, Chongqing Emergency Medical Center, Chongqing University Central Hospital Chongqing University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guixue","family":"Wang","sequence":"additional","affiliation":[{"name":"Bioengineering College, Key Laboratory for Biorheological Science and Technology of Ministry of Education Chongqing University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youqiang","family":"Hu","sequence":"additional","affiliation":[{"name":"Bioengineering College, Key Laboratory for Biorheological Science and Technology of Ministry of Education Chongqing University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, School of Medicine, Bioengineering College, Chongqing Emergency Medical Center, Chongqing University Central Hospital Chongqing University  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wu","family":"Deng","sequence":"additional","affiliation":[{"name":"College of Electronic Information and Automation Civil Aviation University of China  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David 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