{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T02:14:10Z","timestamp":1787019250547,"version":"build-2736575974"},"reference-count":45,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,10,26]],"date-time":"2023-10-26T00:00:00Z","timestamp":1698278400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The International Journal of Lower Extremity Wounds"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p>\n                    We aim to identify the factors associated with the failure of amputation of one to three toes (index toe amputation) in patients with diabetes and foot infection. We conducted a retrospective cohort of 175 patients with diabetes who were hospitalized for moderate to severe foot infection and underwent amputation of one to three toes. A Poisson regression model was used to determine the prevalence ratio (PR) as a measure of association. The mean age was 63.3\u2009\u00b1\u200911.4 years. Fifty-three patients presented failure after undergoing toe amputation (30.3%). Multivariate analysis, adjusted for age and sex, showed the following significant variables: severe infection (PR: 1.78; 95% confidence interval [CI]: 1.14\u20132.78;\n                    <jats:italic>P\u2009=\u2009<\/jats:italic>\n                    0.011), infection by\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    (PR: 2.21; 95% CI: 1.42\u20133.43;\n                    <jats:italic>P\u2009<\/jats:italic>\n                    &lt;\u20090.001), infection by\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    (PR: 2.11; 95% CI: 1.29-3.43;\n                    <jats:italic>P\u2009=\u2009<\/jats:italic>\n                    0.003) and prothrombin time (PR: 1.13; 95% CI: 1.05\u20131.21;\n                    <jats:italic>P\u2009=\u2009<\/jats:italic>\n                    0.001), obesity (PR: 0.58; 95% CI: 0.37\u20130.93;\n                    <jats:italic>P\u2009=\u2009<\/jats:italic>\n                    0.024), and haemoglobin value (PR: 0.92; 95% CI: 0.86\u20130.99;\n                    <jats:italic>P\u2009=\u2009<\/jats:italic>\n                    0.023). About one-third of patients who underwent amputation of one to three toes for diabetic foot infection presented a failure and required a more proximal surgery. Severe infections, isolation of\n                    <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                    and\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    , and prolonged prothrombin time were associated with a higher prevalence of failure. However, obesity and an elevated haemoglobin level were associated with a lower prevalence of failure.\n                  <\/jats:p>","DOI":"10.1177\/15347346231207679","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T02:23:06Z","timestamp":1698373386000},"page":"135-142","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk Factors Associated with Failure of Toe Amputation in Diabetic Foot Infections"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0028-765X","authenticated-orcid":false,"given":"Gerardo","family":"V\u00edquez-Molina","sequence":"first","affiliation":[{"name":"Diabetic foot Unit, San Juan de Dios Hospital, San Jos\u00e9, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Arag\u00f3n-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Department of Surgery, Diabetic Foot Unit. La Paloma Hospital. Las Palmas de Gran Canaria, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Villalobos-Vargas","sequence":"additional","affiliation":[{"name":"Laboratorio Cl\u00ednico y Banco de Sangre, San Jos\u00e9, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebeca","family":"Alvarado-Prado","sequence":"additional","affiliation":[{"name":"School of Public Health, Universidad de Costa Rica, San Jos\u00e9, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Jos\u00e9","family":"Romero-Zu\u00f1iga","sequence":"additional","affiliation":[{"name":"Population Medicine Research Program, School of Veterinary Medicine, Universidad Nacional, Heredia, Costa Rica"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,10,26]]},"reference":[{"key":"e_1_3_2_2_2","unstructured":"Home Resources diabetes L with et al. 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