{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T11:15:14Z","timestamp":1783509314632,"version":"3.55.0"},"reference-count":15,"publisher":"MDPI AG","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"\n Background:<\/jats:bold>\n Lower-extremity amputations are a common complication of poorly controlled diabetes and contribute to significant morbidity and mortality in diabetic patients. We sought to determine whether objective data points obtained on presentation or hospital admission, including white blood cell (WBC) count, hemoglobin A\n 1c<\/jats:sub>\n (HbA\n 1c<\/jats:sub>\n ), C-reactive protein (CRP), and descriptive patient demographics allow for the ability to predict optimal amputation levels and outcomes of lower-extremity amputation in the diabetic population.\n <\/jats:p>\n \n Methods:<\/jats:bold>\n A retrospective analysis of 162 patients was performed evaluating laboratory and descriptive values on hospital presentation for lower-extremity infection during a 16-year period. Occurrence of multiple amputations and level of amputation were assessed against laboratory values to determine whether these objective values would provide clinicians with a better understanding of amputations in the diabetic patient.\n <\/jats:p>\n \n Results:<\/jats:bold>\n The mean patient age was 60.6 years. A significantly higher percentage of patients who underwent amputations through the tibia and fibula or of the foot midtarsal were male compared with patients who underwent amputations of the thigh through femur. Patients who had amputations through the tibia and fibula had a significantly higher WBC count compared with patients who had a transmetatarsal amputation (\n P<\/jats:italic>\n = .03). There was no significant difference in type or quantity of amputations when analyzing HbA\n 1c<\/jats:sub>\n and CRP levels.\n <\/jats:p>\n \n Conclusions:<\/jats:bold>\n An admission WBC count may be used as a predictor of lower-extremity amputation level and outcomes in diabetic infections. Although a statistically significant difference was not found for CRP or HbA\n 1c<\/jats:sub>\n levels between amputation procedures and number of procedures performed, these values remain useful in managing lower-extremity infections in diabetic patients.\n <\/jats:p>","DOI":"10.7547\/21-187","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T12:30:44Z","timestamp":1709555444000},"source":"Crossref","is-referenced-by-count":0,"title":["Association of Demographic Characteristics and Laboratory Values in Diabetic Foot Infections Leading to Lower-Extremity Amputation"],"prefix":"10.3390","volume":"114","author":[{"given":"Allen J.","family":"Kempf","sequence":"first","affiliation":[{"name":"Geisinger Community Medical Center, Scranton, PA. Dr. Kempf is now with Des Moines University, College of Podiatric Medicine and Surgery, Des Moines, IA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellianne M.","family":"Nasser","sequence":"additional","affiliation":[{"name":"Geisinger Community Medical Center, Scranton, PA. Dr. Kempf is now with Des Moines University, College of Podiatric Medicine and Surgery, Des Moines, IA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idorenyin F.","family":"Udoeyo","sequence":"additional","affiliation":[{"name":"Geisinger Community Medical Center, Scranton, PA. Dr. Kempf is now with Des Moines University, College of Podiatric Medicine and Surgery, Des Moines, IA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isana","family":"Fils-Aime","sequence":"additional","affiliation":[{"name":"Temple University School of Podiatric Medicine, Philadelphia, PA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","reference":[{"key":"B1","series-title":"JAPMA","first-page":"224","article-title":"Value of white blood cell count with differential in the acute diabetic foot infection","volume":"86","author":"Armstrong DG","year":"1996","unstructured":"Armstrong DG, Perales TA, Murff RT, et al: Value of white blood cell count with differential in the acute diabetic foot infection. 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Cardiovasc Diabetol 11: 18. 2012."},{"key":"B10","series-title":"Diabet Foot Ankle","doi-asserted-by":"publisher","DOI":"10.3402\/dfa.v2i0.7463","article-title":"Predictive factors for lower extremity amputations in diabetic foot infections","volume":"2","author":"Aziz Z","year":"2011","unstructured":"Aziz Z, Lin WK, Nather A, et al: Predictive factors for lower extremity amputations in diabetic foot infections. Diabet Foot Ankle 2: 10.3402\/dfa.v2i0.7463, 2011."},{"key":"B11","series-title":"BMC Surg","first-page":"113","article-title":"Predictive factors for successful limb salvage surgery in diabetic foot patients","volume":"14","author":"Choi MS","year":"2014","unstructured":"Choi MS, Jeon SB, Lee JH: Predictive factors for successful limb salvage surgery in diabetic foot patients. BMC Surg 14: 113, 2014."},{"key":"B12","series-title":"J Plast Reconstr Aesthet Surg","first-page":"867","article-title":"A multidisciplinary diabetic foot ulcer treatment programme significantly improved the outcome in patients with infected diabetic foot ulcers","volume":"64","author":"Chiu CC","year":"2011","unstructured":"Chiu CC, Huang CL, Weng SF, et al: A multidisciplinary diabetic foot ulcer treatment programme significantly improved the outcome in patients with infected diabetic foot ulcers. J Plast Reconstr Aesthet Surg 64: 867, 2011."},{"key":"B13","series-title":"Diabetes Care","first-page":"1695","article-title":"Developing and validating a risk score for lower-extremity amputation in patients hospitalized for a diabetic foot infection","volume":"34","author":"Lipsky BA","year":"2011","unstructured":"Lipsky BA, Weigelt JA, Sun X, et al: Developing and validating a risk score for lower-extremity amputation in patients hospitalized for a diabetic foot infection. 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Hormones (Athens, Greece)8: 286, 2009."}],"container-title":["Journal of the American Podiatric Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/japmaonline.org\/view\/journals\/apms\/114\/1\/21-187.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/114\/1\/21-187.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/japmaonline.org\/downloadpdf\/journals\/apms\/114\/1\/21-187.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:19:32Z","timestamp":1783505972000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1930-8264\/114\/1\/21187"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":15,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.7547\/21-187","relation":{},"ISSN":["8750-7315"],"issn-type":[{"value":"8750-7315","type":"print"}],"subject":[],"published":{"date-parts":[[2024,1]]}}}