{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T02:44:35Z","timestamp":1785725075502,"version":"3.56.0"},"reference-count":21,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007414","name":"Qassim University","doi-asserted-by":"publisher","award":["QU\u2010APC\u20102026"],"award-info":[{"award-number":["QU\u2010APC\u20102026"]}],"id":[{"id":"10.13039\/501100007414","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Diabetic foot complications, including ulcers, infections, and amputations, remain a major cause of morbidity among individuals with diabetes, primarily driven by neuropathy and peripheral vascular disease. Despite being largely preventable, their burden remains substantial, particularly in high\u2010risk populations. To assess the burden and associated factors of diabetic foot complications among patients attending a tertiary diabetes centre in the Qassim region, Saudi Arabia, between 2021 and 2024. A retrospective cross\u2010sectional study was conducted using medical record data from 4119 patients attending a tertiary referral diabetes and endocrinology centre. Standardised clinical and demographic data were extracted and analysed to estimate the burden of diabetic foot complications and examine associated factors. The mean age of the participants was 58.8\u2009\u00b1\u200910.8\u2009years; 60.5% were male, and 97.8% had type II diabetes. The mean BMI was 28.2\u2009\u00b1\u20092.9\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    , and the mean HbA1c level was 8.9%\u2009\u00b1\u20092.1%. Hypertension was present in 78.9% of participants. Foot ulcers were identified in 65.4% of patients, and 41.2% had a history of lower\u2010extremity amputation. Multivariable logistic regression analysis demonstrated that age, male sex, type II diabetes, smoking, hypertension, elevated BMI, higher HbA1c levels, and lack of participation in diabetes\u2010related educational programs were independently associated with amputation. Male patients had higher adjusted odds of amputation than females (AOR\u2009=\u20091.48, 95% CI: 1.23\u20131.79), while type II diabetes was independently associated with higher odds of amputation (AOR\u2009=\u20091.41, 95% CI: 1.02\u20132.07). A high burden of diabetic foot complications was observed in this tertiary referral cohort, likely reflecting the concentration of advanced and complex cases. Older age, male sex, type II diabetes, smoking, hypertension, elevated BMI, higher HbA1c levels, and lack of participation in diabetes\u2010related educational programs were independently associated with lower\u2010extremity amputation. These findings highlight the importance of earlier referral of high\u2010risk patients, strengthening diabetic foot screening within primary healthcare settings, and enhancing multidisciplinary foot care services to prevent progression to advanced disease and reduce avoidable amputations. However, given the retrospective cross\u2010sectional design, the reported findings should be interpreted as associations rather than causal relationships.\n                  <\/jats:p>","DOI":"10.1111\/iwj.70987","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T01:22:00Z","timestamp":1783041720000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Burden and Associated Factors of Diabetic Foot Complications in a Tertiary Referral Cohort Between 2021 and 2024 in the Qassim Region, Saudi Arabia: A Retrospective Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0654-9702","authenticated-orcid":false,"given":"Mohamed Goda","family":"Elbqry","sequence":"first","affiliation":[{"name":"Department of Medical\u2010Surgical Nursing, College of Nursing Qassim University  Buraydah Saudi Arabia"},{"name":"Department of Nursing, Medical City Qassim University  Buraydah Saudi Arabia"},{"name":"Department of Medical\u2010Surgical Nursing, Faculty of Nursing Suez Canal University  Ismailia City Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1709-0132","authenticated-orcid":false,"given":"Fatma Mohamed","family":"Elmansy","sequence":"additional","affiliation":[{"name":"Department of Medical\u2010Surgical Nursing, College of Nursing Qassim University  Buraydah Saudi Arabia"},{"name":"Department of Nursing, Medical City Qassim University  Buraydah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Talal Ali","family":"F. Alharbi","sequence":"additional","affiliation":[{"name":"Department of Community, Psychiatric and Mental Health Nursing, College of Nursing Qassim University  Buraydah Saudi Arabia"},{"name":"Abdullah Al\u2010Othaim Diabetes Center, Medical City Qassim University  Buraydah Saudi Arabia"},{"name":"Sulaiman AlRajhi University, College of Nursing Department of Family and Community Health, AlBukayriyah  Qassim Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Badahdah","sequence":"additional","affiliation":[{"name":"Diabetes and Endocrinology Center King Fahd Specialist Hospital  Buraydah Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mona Ibrahim","family":"Hebeshy","sequence":"additional","affiliation":[{"name":"Department of Medical\u2010Surgical Nursing, Faculty of Nursing Suez Canal University  Ismailia City Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0228-3003","authenticated-orcid":false,"given":"Mohammed Nader","family":"Shalaby","sequence":"additional","affiliation":[{"name":"Sports Biology, Biological Sciences and Sports Health Department, Faculty of Physical Education Suez Canal University  Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"issue":"10","key":"e_1_2_16_2_1","first-page":"3","article-title":"Awareness of General Population of Saudi Arabia Toward Diabetic Complications","volume":"7","author":"Alanazi M. A.","year":"2021","journal-title":"Trends and Emerging Practices in Healthcare Project Management: The Role of Corona Crisis Management Room to Control COVID\u201019 Spread in Aseer Region, Saudi Arabia"},{"issue":"2","key":"e_1_2_16_3_1","first-page":"e53531","article-title":"Diabetic Foot Complications in Saudi Arabia: A Retrospective Study","volume":"16","author":"Zaki S. M.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_16_4_1","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation","year":"2025"},{"key":"e_1_2_16_5_1","doi-asserted-by":"publisher","DOI":"10.2174\/1573399811666150724095130"},{"key":"e_1_2_16_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2021.103174"},{"issue":"1","key":"e_1_2_16_7_1","first-page":"931","article-title":"Prevalence and Related Risk Factors of Diabetic Foot Ulcers Among Patients With Diabetes in Saudi Arabia: A Cross\u2010Sectional Study","volume":"6","author":"Almalki A. G.","year":"2024","journal-title":"Cahiers Magellanes\u2010NS"},{"key":"e_1_2_16_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtv.2021.07.006"},{"issue":"10","key":"e_1_2_16_9_1","first-page":"65","article-title":"The Level of Knowledge and Awareness About Diabetes and Diabetic Foot Among the Taif General Population","volume":"7","author":"Alotaibi H.","year":"2022","journal-title":"Middle East Journal of Family Medicine"},{"key":"e_1_2_16_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20010187"},{"key":"e_1_2_16_11_1","doi-asserted-by":"crossref","unstructured":"P. S.Moussa A.Alshammeri W.Fahd Y.Al\u2010Shammary N. S.Alshammeri andY. S.Alsugh \u201cPattern of Diabetic Foot Disorder in King Khalid Hospital Hail Saudi Arabia (2013) \u201d2016 https:\/\/doi.org\/10.21275\/v5i1.nov152511.","DOI":"10.21275\/v5i1.NOV152511"},{"key":"e_1_2_16_12_1","doi-asserted-by":"publisher","DOI":"10.36348\/sjm.2023.v08i09.009"},{"key":"e_1_2_16_13_1","doi-asserted-by":"publisher","DOI":"10.5742\/mewfm.2021.940105"},{"key":"e_1_2_16_14_1","doi-asserted-by":"publisher","DOI":"10.21474\/ijar01\/2368"},{"key":"e_1_2_16_15_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.53356"},{"key":"e_1_2_16_16_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_248_19"},{"key":"e_1_2_16_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104\u2010018\u20103372\u2010z"},{"key":"e_1_2_16_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1534734615601542"},{"key":"e_1_2_16_19_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.55826"},{"key":"e_1_2_16_20_1","doi-asserted-by":"publisher","DOI":"10.47310\/jpms2025140520"},{"key":"e_1_2_16_21_1","doi-asserted-by":"publisher","DOI":"10.9734\/jpri\/2021\/v33i54a33718"},{"key":"e_1_2_16_22_1","doi-asserted-by":"publisher","DOI":"10.4103\/jfmpc.jfmpc_1109_23"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70987","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/iwj.70987","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70987","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T01:53:36Z","timestamp":1785722016000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.70987"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":21,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/iwj.70987"],"URL":"https:\/\/doi.org\/10.1111\/iwj.70987","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-01-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-02","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70987"}}