{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:57Z","timestamp":1784557077094,"version":"3.55.0"},"reference-count":10,"publisher":"Bioscientifica","issue":"2","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000041","name":"American Diabetes Association","doi-asserted-by":"crossref","award":["CDTR #5"],"award-info":[{"award-number":["CDTR #5"]}],"id":[{"id":"10.13039\/100000041","id-type":"DOI","asserted-by":"crossref"}]},{"name":"NY Regional Center for Diabetes Translational Research","award":["342843"],"award-info":[{"award-number":["342843"]}]}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Lower extremity amputation secondary to diabetic foot ulcers (DFU) is associated with a 50% mortality rate within 5 years. The aim of this case series is to understand the risk factors and management of DFU leading to above-knee or below-knee amputation at an urban medical center. We conducted a retrospective review of the medical history, foot examination findings, noninvasive vascular studies, angiographic imaging, and radiology results from hospital stays during which patients underwent amputation. A total of 35 patients with DFU who underwent amputation between 2016 and 2021 were evaluated. Of these, 16 ambulatory patients had complete medical data and were included in the analysis. Risk factors for amputation, clinical presentation, diagnostic findings (e.g. vascular studies or imaging), and amputation approaches were analyzed. Our study found significant variability in the medical history, presentation, and management of patients with DFU who underwent lower extremity amputations, including differences in vascular abnormalities and the timing of care. Poor glucose control (median HbA1c of 10.3%) and delayed presentation likely contributed to tissue loss and amputation. Understanding the individual medical presentations and management of patients undergoing leg amputation secondary to DFU may inform the development of more effective strategies to prevent this complication in patients with diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                    <jats:list list-type=\"simple\">\n                      <jats:list-item>\n                        <jats:p>There is significant variability in the presentation and progression of diabetic foot ulcers (DFUs).<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Diagnostic evaluation of DFU varies between patients; a more standardized evaluation to inform best practices could be useful.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Socioeconomic status (SES) plays a role in the increased risk of amputations among DFU patients, including delay in care and access to limb salvage programs.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Multidisciplinary care, including early detection of DFU, patient education, and routine screenings, is essential for improving outcomes and reducing the risk of amputations in high-risk DFU patients.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-25-0036","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T05:41:00Z","timestamp":1747806060000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":0,"title":["Variation in clinical presentation of hospitalized patients with diabetic foot ulcers who underwent lower leg amputation in the Bronx from 2016\u20132021"],"prefix":"10.1530","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2715-7406","authenticated-orcid":true,"given":"Ava","family":"Tsapatsaris","sequence":"first","affiliation":[{"name":"Gallatin School of Individualized Study New York University, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise A","family":"Levy","sequence":"additional","affiliation":[{"name":"Department of Podiatric Medicine, Montefiore Medical Center\/Albert Einstein College of Medicine, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyson K","family":"Myers","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Montefiore Medical Center\/Albert Einstein College of Medicine Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna P","family":"Daily","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease, Department of Medicine, Montefiore Medical Center\/Albert Einstein College of Medicine Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manasa","family":"Kanneganti","sequence":"additional","affiliation":[{"name":"Department of Surgery, Montefiore Medical Center\/Albert Einstein College of Medicine, Bronx, New York, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Diabetes Care","first-page":"1679","article-title":"Comprehensive foot examination and risk assessment: a report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists","volume":"31","author":"Boulton AJ","year":"2008","unstructured":"Boulton AJ\n, \nArmstrong DG\n, \nAlbert SF\n, et al.\n Comprehensive foot examination and risk assessment: a report of the task force of the foot care interest group of the American Diabetes Association, with endorsement by the American Association of Clinical Endocrinologists. Diabetes Care 2008 31 1679\u20131685. (https:\/\/doi.org\/10.2337\/dc08-9021)"},{"key":"bib2","series-title":"Diabetes Metab Res Rev","article-title":"IWGDF\/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections (IWGDF\/IDSA 2023)","volume":"40","author":"Senneville \u00c9","year":"2024","unstructured":"Senneville \u00c9\n, \nAlbalawi Z\n, \nvan Asten SA\n, et al.\n IWGDF\/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections (IWGDF\/IDSA 2023). Diabetes Metab Res Rev 2024 40 e3687. (https:\/\/doi.org\/10.1002\/dmrr.3687)"},{"key":"bib3","series-title":"J Vasc Surg","first-page":"855","article-title":"Discussion","volume":"67","author":"Fisher DF","year":"2018","unstructured":"Fisher DF\n & \nPhair J\n\n. Discussion. J Vasc Surg 2018 67 855\u2013856. (https:\/\/doi.org\/10.1016\/j.jvs.2017.08.087)"},{"key":"bib4","series-title":"Endocr Pract","first-page":"758","article-title":"The risk of and associated demographic and laboratory variables for amputations for inpatients with diabetic foot ulcers","volume":"30","author":"Xu S","year":"2024","unstructured":"Xu S\n, \nHerrera A\n, \nSchechter C\n, et al.\n The risk of and associated demographic and laboratory variables for amputations for inpatients with diabetic foot ulcers. Endocr Pract 2024 30 758\u2013764. (https:\/\/doi.org\/10.1016\/j.eprac.2024.04.019)"},{"key":"bib5","series-title":"J Vasc Surg","first-page":"23S","article-title":"Toe and flow: essential components and structure of the amputation prevention team","volume":"52","author":"Rogers LC","year":"2010","unstructured":"Rogers LC\n, \nAndros G\n, \nCaporusso J\n, et al.\n Toe and flow: essential components and structure of the amputation prevention team. J Vasc Surg 2010 52 (Supplement 3) 23S\u201327S. (https:\/\/doi.org\/10.1016\/j.jvs.2010.06.004)"},{"key":"bib6","series-title":"Eur J Vasc Endovasc Surg","first-page":"362","article-title":"Editor\u2019s choice \u2013 the prognostic value of the WIfI classification in patients with chronic limb threatening ischaemia: a systematic review and meta-analysis","volume":"58","author":"van Reijen NS","year":"2019","unstructured":"van Reijen NS\n, \nPonchant K\n, \nUbbink DT\n, et al.\n Editor\u2019s choice \u2013 the prognostic value of the WIfI classification in patients with chronic limb threatening ischaemia: a systematic review and meta-analysis. Eur J Vasc Endovasc Surg 2019 58 362\u2013371. (https:\/\/doi.org\/10.1016\/j.ejvs.2019.03.040)"},{"key":"bib7","series-title":"Diabetologia","first-page":"840","article-title":"Association between glycated haemoglobin and the risk of lower extremity amputation in patients with diabetes mellitus-review and meta-analysis","volume":"53","author":"Adler AI","year":"2010","unstructured":"Adler AI\n, \nErqou S\n, \nLima TA\n, et al.\n Association between glycated haemoglobin and the risk of lower extremity amputation in patients with diabetes mellitus-review and meta-analysis. Diabetologia 2010 53 840\u2013849. (https:\/\/doi.org\/10.1007\/s00125-009-1638-7)"},{"key":"bib8","series-title":"Int Wound J","article-title":"The incidence of lower extremity amputation and its associated risk factors in patients with diabetic foot ulcers: a meta-analysis","volume":"21","author":"Luo Y","year":"2024","unstructured":"Luo Y\n, \nLiu C\n, \nLi C\n, et al.\n The incidence of lower extremity amputation and its associated risk factors in patients with diabetic foot ulcers: a meta-analysis. Int Wound J 2024 21 e14931. (https:\/\/doi.org\/10.1111\/iwj.14931)"},{"key":"bib9","series-title":"Diabetes Care","first-page":"1464","article-title":"Evaluation of the effectiveness of remote foot temperature monitoring for prevention of amputation in a large integrated health care system","volume":"46","author":"Littman AJ","year":"2023","unstructured":"Littman AJ\n, \nTimmons AK\n, \nKorpak A\n, et al.\n Evaluation of the effectiveness of remote foot temperature monitoring for prevention of amputation in a large integrated health care system. Diabetes Care 2023 46 1464\u20131468. (https:\/\/doi.org\/10.2337\/dc22-1492)"},{"key":"bib10","series-title":"J Vasc Surg","first-page":"1433","article-title":"A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers","volume":"71","author":"Musuuza J","year":"2020","unstructured":"Musuuza J\n, \nSutherland BL\n, \nKurter S\n, et al.\n A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers. J Vasc Surg 2020 71 1433\u20131446.e3. (https:\/\/doi.org\/10.1016\/j.jvs.2019.08.244)"}],"container-title":["Endocrinology, Diabetes &amp; Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2025\/2\/EDM-25-0036.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2025\/2\/EDM-25-0036.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2025\/2\/EDM-25-0036.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:48:36Z","timestamp":1784555316000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3853"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,1]]},"references-count":10,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.1530\/edm-25-0036","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,1]]}}}