{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T17:51:52Z","timestamp":1782323512490,"version":"3.54.5"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:00:00Z","timestamp":1782259200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Diabetes mellitus continues to escalate as a major global health crisis, with diabetic foot infection (DFI) remaining one of the most serious and preventable complications. Despite advances in multidisciplinary care, amputation rates remain high, particularly in low- and middle-income settings. This retrospective study identifies key predictors associated with the level of amputation; major (above the knee) versus minor (at or below the knee) among patients with DFI following surgical decision-making. Electronic medical records of 434 patients admitted with DFI to a tertiary care hospital in Central Malaysia between January 2010 and December 2019 were analysed. Minor amputations accounted for 70.7% of cases, while major amputations comprised the remainder. Most patients (63.8%) presented with advanced disease, with Wagner grade 4 being the most prevalent (40.3%). Binary logistic regression analysis was employed to determine independent predictors of amputation level. Increasing age (OR = 1.06, p\u2009=\u2009.013) and higher Wagner classification (OR = 15.16, p\u2009&lt;\u2009.001) emerged as significant independent predictors of major amputation. These results highlight the need for timely intervention and aggressive limb-salvage strategies in high-risk groups.<\/jats:p>","DOI":"10.1371\/journal.pone.0335328","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T17:31:23Z","timestamp":1782322283000},"page":"e0335328","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors associated with diabetic foot amputation: A retrospective study from a tertiary hospital in Central Malaysia"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7047-0903","authenticated-orcid":true,"given":"Sanjiv","family":"Rampal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2645-0224","authenticated-orcid":true,"given":"Claudia Abreu","family":"Lopes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parichehr","family":"Hadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasantha Kumari","family":"Neela","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,6,24]]},"reference":[{"issue":"3","key":"pone.0335328.ref001","doi-asserted-by":"crossref","DOI":"10.1002\/dmrr.3657","article-title":"Practical guidelines on the prevention and management of diabetes-related foot disease (IWGDF 2023 update)","volume":"40","author":"NC Schaper","year":"2024","journal-title":"Diabetes Metab Res Rev"},{"key":"pone.0335328.ref002","unstructured":"Ministry of Health Malaysia. National Diabetes Registry Report 2013-2019. Putrajaya: MOH; 2020."},{"issue":"2","key":"pone.0335328.ref003","first-page":"41","article-title":"Clinical factors affecting minor amputation in diabetic foot","volume":"22","author":"Z Zakaria","year":"2015","journal-title":"Malays J Med Sci"},{"key":"pone.0335328.ref004","unstructured":"International Diabetes Federation. IDF diabetes atlas. 11th ed. Brussels, Belgium: International Diabetes Federation; 2025. IDF Diabetes Atlas 2025 | Global Diabetes Data & Insights."},{"key":"pone.0335328.ref005","unstructured":"Institute for Public Health (IPH). National Health and Morbidity Survey 2023: non-communicable diseases and healthcare. Ministry of Health Malaysia; 2024. 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