{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T03:56:01Z","timestamp":1794023761703,"version":"4.8.0"},"reference-count":40,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,7,4]],"date-time":"2023-07-04T00:00:00Z","timestamp":1688428800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Diabetic foot ulcer often leads to amputation, and both nutritional status and immune function have been associated with this process. We aimed to investigate the risk factors of diabetic ulcer\u2010related amputation including the Controlling Nutritional Status score and neutrophil\u2010to\u2010lymphocyte ratio biomarker. We evaluated data from hospital in patients with diabetic foot ulcer, performing univariate and multivariate analyses to screen for high\u2010risk factors and Kaplan\u2013Meier analysis to correlate high\u2010risk factors with amputation\u2010free survival. Overall, 389 patients underwent 247 amputations over the follow\u2010up period. After correction to relevant variables, we identified five independent risk factors for diabetic ulcer\u2010related amputation: ulcer severity, ulcer site, peripheral arterial disease, neutrophil\u2010to\u2010lymphocyte ratio and nutritional status. Amputation\u2010free survival was lower for the moderate\u2010to\u2010severe versus mild cases, for the plantar forefoot versus hindfoot location, for the concomitant peripheral artery disease versus without and in the high versus low neutrophil\u2010to\u2010lymphocyte ratio (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01). The results showed that ulcer severity (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01), ulcer site (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01), peripheral artery disease (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01), neutrophil\u2010to\u2010lymphocyte ratio (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.01) and Controlling Nutritional Status score (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05) were independent risk factors for amputation in diabetic foot ulcer patients and have predictive values for diabetic foot ulcer progression to amputation.\n                  <\/jats:p>","DOI":"10.1111\/iwj.14296","type":"journal-article","created":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T01:44:09Z","timestamp":1688521449000},"page":"4050-4060","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Risk factor analysis for diabetic foot ulcer\u2010related amputation including Controlling Nutritional Status score and neutrophil\u2010to\u2010lymphocyte ratio"],"prefix":"10.1111","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8673-1186","authenticated-orcid":false,"given":"Yandan","family":"Zhu","sequence":"first","affiliation":[{"name":"Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongtao","family":"Xu","sequence":"additional","affiliation":[{"name":"Shanghai Traditional Chinese Medicine Integrated Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzhen","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanghai Traditional Chinese Medicine Integrated Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Feng","sequence":"additional","affiliation":[{"name":"Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyu","family":"Liang","sequence":"additional","affiliation":[{"name":"Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liying","family":"Xu","sequence":"additional","affiliation":[{"name":"Shanghai Traditional Chinese Medicine Integrated Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiang","family":"Liang","sequence":"additional","affiliation":[{"name":"Shanghai Traditional Chinese Medicine Integrated Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongjia","family":"Xu","sequence":"additional","affiliation":[{"name":"Shanghai Traditional Chinese Medicine Integrated Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yawen","family":"Li","sequence":"additional","affiliation":[{"name":"Shanghai Traditional Chinese Medicine Integrated Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Le","sequence":"additional","affiliation":[{"name":"Shanghai Traditional Chinese Medicine Integrated Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manchen","family":"Zhao","sequence":"additional","affiliation":[{"name":"Shanghai Traditional Chinese Medicine Integrated Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianfei","family":"Yang","sequence":"additional","affiliation":[{"name":"Shanghai Traditional Chinese Medicine Integrated Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji","family":"Li","sequence":"additional","affiliation":[{"name":"Shanghai Traditional Chinese Medicine Integrated Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yemin","family":"Cao","sequence":"additional","affiliation":[{"name":"Shanghai Traditional Chinese Medicine Integrated Hospital Shanghai University of Traditional Chinese Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,4]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3268"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/07853890.2016.1231932"},{"issue":"2","key":"e_1_2_11_4_1","first-page":"92","article-title":"Chinese Medical Association tissue repair and regeneration branch. Chinese guidelines for the prevention and treatment of diabetic foot (2019 edition) (I) [J]","volume":"11","author":"Chinese Diabetes Society, Chinese Society of Infectious Diseases, Chinese Medical Association","year":"2019","journal-title":"Chin J Diabetes"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/17843286.2020.1800315"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/dme.12509"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1079\/PNS2006507"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2018.08.009"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/15347346211057742"},{"issue":"1","key":"e_1_2_11_10_1","first-page":"38","article-title":"CONUT: a tool for controlling nutritional status. First validation in a hospital population","volume":"20","author":"Ignacio de Ul\u00edbarri J","year":"2005","journal-title":"Nutr Hosp"},{"key":"e_1_2_11_11_1","first-page":"143","article-title":"A classification and treatment program for diabetic, neuropathic, and dysvascular foot problems","volume":"28","author":"Wagner FW","year":"1979","journal-title":"Am Acad Orthop Surg Instruct Course Lect"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2013.03.017"},{"issue":"2","key":"e_1_2_11_13_1","first-page":"S1","article-title":"K\/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification","volume":"39","author":"National Kidney Foundation","year":"2002","journal-title":"Am J Kidney Dis"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/1071100712467980"},{"key":"e_1_2_11_15_1","first-page":"599","article-title":"Sample size estimation in clinical research:(2) observational study","volume":"07","author":"Wan X","year":"2007","journal-title":"J Tradit Chin Med"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-1504"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.5152\/j.aott.2022.22052"},{"issue":"7","key":"e_1_2_11_18_1","article-title":"Predicting amputation in patients with diabetic foot ulcers: a systematic review","volume":"14","author":"Mansoor Z","year":"2022","journal-title":"Cureus"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.2400"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.12701\/yujm.2020.00129"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.diabres.2019.107905"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000112642.63927.54"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-008-0940-0"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.3906\/sag-1803-217"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13047-019-0345-y"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2022.851274"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-1596"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2007.10.007"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/jpen.1451"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00452.2009"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-018-1233-9"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2015.02.009"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2021.738045"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11051314"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1093\/jn\/133.1.336S"},{"key":"e_1_2_11_36_1","first-page":"702","article-title":"The neutrophil\u2010to\u2010lymphocyte ratio: a narrative review","volume":"10","author":"Faria SS","year":"2016","journal-title":"Ecancermedicalscience"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.10.094"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1677\/joe.0.1820145"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S284583"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S165967"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11481-006-9036-0"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.14296","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T19:59:52Z","timestamp":1744574392000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.14296"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,4]]},"references-count":40,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1111\/iwj.14296"],"URL":"https:\/\/doi.org\/10.1111\/iwj.14296","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,4]]},"assertion":[{"value":"2023-04-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}