{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T10:50:00Z","timestamp":1778842200809,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"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":["Vascular"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lower extremity amputations (LEA) are serious complications of the infected diabetic foot. Subsequent amputations are underreported and the occurrence of an ipsilateral second re-amputation (third amputation) is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective study of a continuous series of patients admitted for LEA due to diabetic foot complications, with a minimum of 2\u00a0years of follow-up after the first re-amputation. A total of 111 patients comprising 149 index amputation; 97 and 52 cases in the minor and major type groups, respectively. The primary outcomes were the observed frequencies of first and second re-amputations with comparative analysis based on amputation type. Logistic regression analysis was used to look for independent risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 149 index LEA cases, 111 cases (74.5%) had no re-amputation. First re-amputation frequencies were 25.5%, 35%, and 7.7% for the whole sample, minor, and major groups, respectively. Second re-amputation frequencies were 34.2%, 31.6%, and 2.6% for the whole sample, minor, and major groups, respectively. Infection re-occurrence was the cause in 89.5% and 100% of cases for first and second re-amputation. Out of the 13 second re-amputation cases in the minor group, 30.7% were minor and 69.3% were major amputations. The mean time for the first re-amputation was 5.4 \u00b1 9.4\u00a0months and that for the second re-amputation was 9.5 \u00b1 7.1\u00a0months (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .04). For the first re-amputation, independent risk factors were smoking (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .04) and creatinine level (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .02) outcome. For the second re-amputation outcome, male sex was the only independent variable (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study demonstrated that a second re-amputation, mostly major, was needed in more than one-third among first re-amputation cases. Second re-amputation could be a relevant major endpoint outcome in this frail population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17085381251339235","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T09:49:57Z","timestamp":1745833797000},"page":"497-504","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ipsilateral third amputation following lower extremity index amputation for diabetic foot infection"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0094-9892","authenticated-orcid":false,"given":"Kaissar","family":"Yammine","sequence":"first","affiliation":[{"name":"Lebanese American University Medical Center-Rizk Hospital"},{"name":"Lebanese American University Medical Center-Rizk Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Omar","family":"Honeine","sequence":"additional","affiliation":[{"name":"Lebanese American University Medical Center-Rizk Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Mouawad","sequence":"additional","affiliation":[{"name":"Lebanese American University Medical Center-Rizk Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghadi","family":"Abou Orm","sequence":"additional","affiliation":[{"name":"Lebanese American University Medical Center-Rizk Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Youssef","family":"Jamaleddine","sequence":"additional","affiliation":[{"name":"Lebanese American University Medical Center-Rizk Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8396-4339","authenticated-orcid":false,"given":"Fady","family":"Hayek","sequence":"additional","affiliation":[{"name":"Lebanese American University Medical Center-Rizk Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chahine","family":"Assi","sequence":"additional","affiliation":[{"name":"Lebanese American University Medical Center-Rizk Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464-5491.2002.00642.x"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67698-2"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1534734619888361"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/1938640019857795"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1534734620923425"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2020.1261"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/1938640018819784"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.RVW.19.00162"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2016.01.012"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2020.07.086"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2020.06.026"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjdrc-2021-002325"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.3109\/03093648009164567"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/17085381231194964"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2012.02.011"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/iwj.12249"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.2337\/dc19-2337"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2010.11.013"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.29.03.06.dc05-1992"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2019.10.063"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1067-2516(97)80116-0"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.22.7.1029"},{"key":"e_1_3_3_25_2","first-page":"88","article-title":"Use of administrative data to risk adjust amputation rates in a national cohort of Medicare-enrolled veterans with diabetes","volume":"43","author":"Tseng CL","year":"2005","unstructured":"Tseng CL, Rajan M, Miller DR, et al. Use of administrative data to risk adjust amputation rates in a national cohort of Medicare-enrolled veterans with diabetes. Med Care 2005; 43: 88\u201392.","journal-title":"Med Care"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/ans.15351"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.7547\/87507315-87-6-255"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2482-14-113"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1177\/1534734609334808"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199307000-00032"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.fas.2023.07.004"}],"container-title":["Vascular"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17085381251339235","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17085381251339235","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17085381251339235","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:41:13Z","timestamp":1777707673000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17085381251339235"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":30,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1177\/17085381251339235"],"URL":"https:\/\/doi.org\/10.1177\/17085381251339235","relation":{},"ISSN":["1708-5381","1708-539X"],"issn-type":[{"value":"1708-5381","type":"print"},{"value":"1708-539X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,28]]}}}