SynthesisPloS one2020
Risk factors for lower extremity amputation in patients with diabetic foot ulcers: A meta-analysis.
Synthesis in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers, 8 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
110 citing papers in PubMed, 8 syntheses or guidelines pooled it, 201 citations in OpenAlex.
- Less Is More? Physical Inactivity and Increased Risk of Diabetes-Related Foot Ulceration-A Systematic Review.Diabetes/metabolism research and reviews · 2026Pooled it
- Risk Factors for Foot-Related Hospitalisations in Adults With and Without Diabetes: A Systematic Review.Journal of foot and ankle research · 2026Pooled it
- Diabetes Foot Ulcer Prevention: A Review of Footwear Width Assessment for At-Risk Feet.Journal of foot and ankle research · 2025Pooled it
- Risk factors associated with the recurrence of diabetic foot ulcers: A meta-analysis.PloS one · 2025Pooled it
- Non-surgical interventions for preventing contralateral tissue loss and amputation in dysvascular patients with a primary major lower limb amputation.The Cochrane database of systematic reviews · 2024Pooled it
- The incidence of lower extremity amputation and its associated risk factors in patients with diabetic foot ulcers: A meta-analysis.International wound journal · 2024Pooled it
- Incidence and risk factors for amputation in Chinese patients with diabetic foot ulcers: a systematic review and meta-analysis.Frontiers in endocrinology · 2024Pooled it
- Effect of diabetic foot ulcers and other risk factors on the prevalence of lower extremity amputation: A meta-analysis.International wound journal · 2023Pooled it
- High Prescription Rate of Medications With Rifampin Drug-drug Interactions in Patients With Diabetic Foot Osteomyelitis: Should Rifabutin Be Included in Clinical Trials for Adjunctive Therapy?Open forum infectious diseases · 2024Trial
- Negative pressure wound therapy (NPWT) is superior to conventional moist dressings in wound bed preparation for diabetic foot ulcers: A randomized controlled trial.Saudi medical journal · 2023Trial
- Clinical Classification of the Diabetic Foot Syndrome Adapted to ICD-10 as a Solution to the Problem of Diagnostics, Statistics and Standardisation.Medicina (Kaunas, Lithuania) · 2021Trial
- Folinic Acid Improves Healing of Diabetic Foot Ulcers.Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair SocietyTrial
- Activating the cellular scavenger: A bioactive hydrogel promotes diabetic wounds via plant exosome-like nanovesicles enhanced macrophage efferocytosis.Bioactive materials · 2026Article
- Effects of Terminalia fagifolia mart. extract combined with photobiomodulation on diabetic foot ulcers: protocol for a randomized single-blind clinical trial.Lasers in medical science · 2026Article
- Development of a core descriptor set for studies assessing interventions for diabetes-related foot ulceration.Diabetologia · 2026Article
- Investigating the Cellular and Tissue Response to Herbal Glucose/Cellulose-based Mesoporous Graphene Frameworks in a Rat Diabetic Wounds Model.Cell biochemistry and biophysics · 2026Article
- Incidence and Risk Factors of Stump Complications Following Amputation in Patients With Diabetes: A Retrospective Analysis of the Nationwide Inpatient Sample.World journal of surgery · 2026Article
- Clinical Characteristics and Outcomes of Toe Amputation Among Sudanese Diabetic Patients in Jabir Abu-Eliz Diabetic Centre at Khartoum, 2021: A Cross Sectional Study.Health science reports · 2026Article
- Diabetes-Related Lower Limb Amputations in the Rio Grande Valley of Texas: A Focused Look at a Historical Health Disparity.Journal of racial and ethnic health disparities · 2026Article
- Risk Factors for Diabetic Foot Ulcers and the Role of Thermal Imaging in Early Detection.Cureus · 2026Article
50 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeA considerable number of diabetic foot ulcer (DFU) patients require amputation every year, which worsens their quality of life, aggravates the social burden, and shortens their life expectancy. Considering these negative effects, it is important to explore the relative risk factors affecting amputation in DFU patients.
methodsThe PubMed, SCIE and Embase databases were comprehensively searched for prospective or retrospective studies published before October 31, 2019. All English language studies involving DFU patients were included, and RevMan 5.3 software was used to analyse the data.
resultsThis meta-analysis includes 21 studies involving 6505 participants, including 2006 patients who required a lower limb amputation. The following variables were associated with an increased risk of amputation: male sex (odds ratios (OR) = 1.30, 95% confidence interval (CI) = 1.16~1.46, P<0.00001), smoking history (OR = 1.19, 95% CI = 1.04~1.35, P = 0.009), a history of foot ulcers (OR = 2.48, 95% CI = 2.00~3.07, P<0.00001), osteomyelitis (OR = 3.70, 95% CI = 3.02~4.53, P<0.00001), gangrene (OR = 10.90, 95% CI = 5.73~20.8, P<0.00001), a lower body mass index (mean difference IV (MD) = -0.88, 95% CI = -1.30~-0.47, P<0.0001), and a higher white blood cell count (MD = 2.42, 95% CI = 2.02~2.82, P<0.00001). However, age (MD = 1.24, 95% CI = -0.45~2.93, P = 0.15), type of diabetes (OR = 0.96, 95% CI = 0.61~1.52, P = 0.86), hypertension (OR = 1.19, 95% CI = 0.96~1.47, P = 0.12), and HbA1c level (MD = 0.02, 95% CI = -0.28~0.33, P = 0.87) were not associated with amputation in patients with DFU.
conclusionsOur meta-analysis identified several risk factors for amputation in DFU patients, including the male sex, a smoking history, a history of foot ulcers, osteomyelitis, gangrene, a lower body mass index, and a higher white blood cell count. Once gangrene occurs, the risk of amputation rapidly increases.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.