{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:39:24Z","timestamp":1787067564558,"version":"build-2736575974"},"reference-count":34,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"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":[[2026,9]]},"abstract":"<jats:p>\n                    Determining the optimal amputation level in diabetic foot (DF) and peripheral artery disease (PAD) patients is crucial for minimizing reamputation risk while preserving functionality. The Society for Vascular Surgery Wound, Ischemia, and Foot Infection (SVS WIfI) and International Working Group on Diabetic Foot (IWGDF) scoring systems are widely used for risk stratification, but their predictive value for reamputation remains unclear. The current study aimed to evaluate the predictive utility of these scoring systems for reamputation risk in patients undergoing amputations due to DF or PAD. A retrospective cohort study was conducted on 108 patients who underwent unilateral amputations due to DF or PAD between 2016 and 2021. Patients were categorized based on WIfI and IWGDF classifications, and clinical outcomes, including reamputation rates, ICU admissions, and mortality, were analyzed using logistic regression and post hoc analyses. Reamputation occurred in 41 (38%) patients. Higher WIfI (OR: 3.85, 95% CI: 2.10-7.05,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.001) and severe IWGDF scores (OR: 3.25, 95% CI: 1.80-5.88,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.008) significantly correlated with increased reamputation risk. Patients with high-risk scores also exhibited higher ICU admission (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.03) and mortality rates (\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.01). Male gender (OR: 3.47, 95% CI: 1.45-8.31,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.005), diabetes (OR: 2.32, 95% CI: 1.10-4.90,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.027), and prolonged hospitalization (OR: 1.04, 95% CI: 1.01-1.08,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009=\u2009.021) were independent predictors, while above-ankle amputations were protective for reamputation (OR: 0.22, 95% CI: 0.11-0.43,\n                    <jats:italic toggle=\"yes\">P<\/jats:italic>\n                    \u2009&lt;\u2009.001). Both scoring systems are effective in predicting reamputation risk, with WIfI providing a more comprehensive risk assessment. Combining these tools may enhance decision-making and improve patient outcomes in terms of reamputation prevention, hospital stay, ICU admission, and mortality.\n                  <\/jats:p>","DOI":"10.1177\/15347346251333835","type":"journal-article","created":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T10:22:13Z","timestamp":1744280533000},"page":"1028-1037","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Exploring the Relationship Between SVS WIfI and IWGDF Scoring Systems and Reamputation Risk in Patients With Diabetic Foot and Peripheral Artery Disease"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0189-1645","authenticated-orcid":false,"given":"Alkan","family":"Bayrak","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, University of Health Sciences, Bak\u0131rk\u00f6y Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8281-9885","authenticated-orcid":false,"given":"Mustafa","family":"Yal\u0131n","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Elaz\u0131\u011f Fethi Sekin City Hospital, Elaz\u0131\u011f, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5594-4138","authenticated-orcid":false,"given":"Mehmet Utku","family":"\u00c7ift\u00e7i","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Sultan 2. Abdulhamit Han Training and Research Hospital, \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3696-9644","authenticated-orcid":false,"given":"Malik","family":"\u00c7elik","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, University of Health Sciences, Bak\u0131rk\u00f6y Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2412-9725","authenticated-orcid":false,"given":"Vedat","family":"\u00d6zt\u00fcrk","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, University of Health Sciences, Bak\u0131rk\u00f6y Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serdar Hakan","family":"Basaran","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, University of Health Sciences, Bak\u0131rk\u00f6y Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.12.041"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2014.12.005"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2011.206"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1538574416682159"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/15347346231208342"},{"key":"e_1_3_2_7_2","article-title":"WIfi classification: The society for vascular surgery lower extremity threatened limb classification system, a literature review","volume":"19","author":"Cerqueira LO","year":"2020","unstructured":"Cerqueira LO, Duarte EG, Barros ALS, Cerqueira JR, de Ara\u00fajo WJB. WIfi classification: The society for vascular surgery lower extremity threatened limb classification system, a literature review. J Vasc Bras. 2020;19:e20190070.","journal-title":"J Vasc Bras"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3686"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2019.03.040"},{"issue":"1","key":"e_1_3_2_10_2","article-title":"Guidelines on diagnosis, prognosis, and management of peripheral artery disease in patients with foot ulcers and diabetes (IWGDF 2019 update)","volume":"36","author":"Hinchliffe RJ","year":"2020","unstructured":"Hinchliffe RJ, Forsythe RO, Apelqvist J, et al. Guidelines on diagnosis, prognosis, and management of peripheral artery disease in patients with foot ulcers and diabetes (IWGDF 2019 update). Diabetes Metab Res Rev. 2020;36(Suppl 1):e3276.","journal-title":"Diabetes Metab Res Rev"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3645"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1067\/msy.2001.115359"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2021.06.006"},{"issue":"4","key":"e_1_3_2_14_2","first-page":"51","article-title":"Wound, ischemia, foot infection (wifi) classification system and its predictive ability concerning amputation-free survival, mortality and Major limb amputation in A Portuguese population: A single center experience","volume":"30","author":"Alves DG","year":"2024","unstructured":"Alves DG, Ferreira V, Teixeira G, et al. Wound, ischemia, foot infection (wifi) classification system and its predictive ability concerning amputation-free survival, mortality and Major limb amputation in A Portuguese population: A single center experience. Port J Card Thorac Vasc Surg. 2024;30(4):51-58.","journal-title":"Port J Card Thorac Vasc Surg"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/dmrr.3687"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.2340\/17453674.2024.39963"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.55730\/1300-0144.5587"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2009.04.013"},{"issue":"5","key":"e_1_3_2_19_2","first-page":"127","article-title":"The influence of gender as a risk factor in diabetic foot ulceration.","volume":"20","author":"Dinh T","year":"2008","unstructured":"Dinh T, Veves A. The influence of gender as a risk factor in diabetic foot ulceration. Wounds. 2008;20(5):127-131.","journal-title":"Wounds"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.08.005"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.01.063"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.09.055"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2017.12.079"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.08.107"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2014.11.045"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2014.10.030"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/1071100712467980"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-1083"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc14-1598"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.29.03.06.dc05-1992"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2013.06.055"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2017.06.004"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s004020000207"},{"key":"e_1_3_2_34_2","first-page":"100","article-title":"Diyabetik ayakta alt ekstremite amputasyonlar\u0131","volume":"3","author":"T\u00fckenmez M","year":"2005","unstructured":"T\u00fckenmez M, \u00c7ekin T, Karata\u015f C, Per\u00e7in S, Tezeren G. Diyabetik ayakta alt ekstremite amputasyonlar\u0131. C. \u00dc. T\u0131p Fak\u00fcltesi Dergisi. 2005;3:100-104.","journal-title":"C. \u00dc. T\u0131p Fak\u00fcltesi Dergisi"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2016.04.001"}],"container-title":["The International Journal of Lower Extremity Wounds"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15347346251333835","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15347346251333835","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15347346251333835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T11:47:35Z","timestamp":1786103255000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15347346251333835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,10]]},"references-count":34,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/15347346251333835"],"URL":"https:\/\/doi.org\/10.1177\/15347346251333835","relation":{},"ISSN":["1534-7346","1552-6941"],"issn-type":[{"value":"1534-7346","type":"print"},{"value":"1552-6941","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,10]]}}}