Predicting 365-Day Lower-Limb Amputation at Discharge After Diabetes-Related Foot Ulcer Hospitalization: Development and Temporal Validation

Clicks: 11
ID: 331989
2026
Free PDF
Article Quality & Performance Metrics
Overall Quality
Not rated
Combines reader engagement with the AI quality analysis. This article has not been analysed, so there is no overall score — reader engagement is measured and shown alongside.
AI Quality Assessment
Not analyzed
Readership in this journal
Emerging

Ranked #256 of 295 articles by views in Open forum infectious diseases

Most read Least read

Bar heights use a square-root scale. Only the 120 most-read articles are drawn; the journal has 295 in total.

Mint this article as an NFT
Not yet minted

Create a permanent, verifiable on-chain record of this article on the Scimatic Network. The NFT is held in your Journament account, and you can withdraw it to your own wallet at any time.

5 SUSD one-off · no wallet required
Sign in to mint
Abstract
Abstract Background Patients discharged after diabetes-related foot ulcer hospitalization remain at risk of limb loss. We developed and temporally validated discharge-time models for 365-day amputation, comparing clinical-plus-discharge predictors with a fuller set including contextual information. Methods Epic Cosmos provided 431,493 development patients discharged in 2016–2024 and 36,823 temporal-validation patients discharged in January–June 2025. Cause-specific Cox models estimated any and major amputation with death as a competing event. Model C included clinical, contextual, and discharge variables; Model D omitted contextual variables. Models were compared using discrimination, calibration, and decision curves. Results Observed 365-day cumulative incidences were 19.3% for any amputation and 6.4% for major amputation. Model C areas under the receiver operating characteristic curve were 0.710 and 0.737, compared with 0.711 and 0.736 for Model D. Corresponding calibration slopes were 1.003 and 1.026 for Model C and 1.010 and 1.025 for Model D. Brier scores were similar. Gangrene and peripheral artery disease had the largest joint Wald statistics in Model C. Its highest-risk quintile contained 40.6% of any-amputation and 49.6% of major-amputation events. Conclusions Models C and D showed similar performance, with moderate discrimination and risk enrichment. These findings do not establish superiority of the fuller model, irrelevance of contextual factors, or improved patient outcomes. Independent validation, local recalibration, and prospective impact evaluation are required before clinical use.
Reference Key
openalex_W7221145722 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Yuriko Fukuta, Mayar Al Mohajer
Journal Open forum infectious diseases
Year 2026
DOI
10.1093/ofid/ofag673
URL
https://doi.org/10.1093/ofid/ofag673
Keywords Keywords not found

Citations

No citations found. To add a citation, contact the admin at info@scimatic.org

Comments

No comments yet. Be the first to comment on this article.