Risk factors and mortality for amputations in the diabetic foot: a nationwide cohort study
Authors' conclusion
Major amputation in people with DFUs is associated with advanced age, vascular disease, comorbidities, and increased mortality. In contrast, minor amputation is linked to better survival. Limb-sparing approaches may improve long-term outcomes in this high-risk population.
Study context
- Population
- People with diabetic foot ulcers (DFUs) who underwent lower extremity amputation, Korean National Health Insurance Service cohort (2002–2020)
- Participants
- 40,809 people
- Exposure
- Major vs minor amputation
- Outcome
- Mortality
Methodological detailsnationwide, longitudinal, Korean National Health Insurance Service data (2002-2020)
- Nationwide
- Longitudinal
- Korean National Health Insurance Service data (2002-2020)
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Survival
- Patient characteristics and comorbidities
- P < 0.001
- Patient characteristics and comorbidities: comorbidities (end-stage renal disease (ESRD), dementia, cerebrovascular disease, ischemic heart disease) more frequent with Major
Patient characteristics and comorbidities
- Major: higher proportion of males, older age, lower income; revascularization and top-tier antibiotics more common
Predictors of mortality
- Dementia, ESRD and prior major amputation had the highest adjusted HRs for mortality
Original publication
Risk factors and mortality for amputations in the diabetic foot: a nationwide cohort study. Diabetes Res Clin Pract. Published 23 August 2025. doi:10.
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