Risk score for lower-limb amputation and its ability to predict major kidney and cardiovascular events in people with type 1 diabetes
Performance · LLAResult — go to the resultMultivariable-adjusted HR 6.02 95% CI 1.92–18.89Authors' conclusion
This newly developed 10-year LLA risk score achieved excellent ability to identify individuals with type 1 diabetes at high risk for LLA, kidney failure, CVD, and MACE.
Study context
- Population
- Individuals with T1D in prospective French and Belgian cohorts (GENEDIAB, GENESIS); external validation in SURGENE247 in validation cohort
- Participants
- 828 individuals
- Comparison
- Highest vs lowest lower-limb amputation (LLA) risk score
- Outcome
- Non-traumatic lower-limb amputation (LLA) above the metatarsophalangeal joint
- Follow-up
- 10-year risk
Methodological detailsprospective cohorts, external validation
- Prospective cohorts
- External validation
Performance
LLA · 12 years of follow-up
Multivariable-adjusted HR
6.02
95% CI 1.92–18.89
Highest scorevs Lowest score
multivariable-adjusted HR 6.02 (95% CI 1.92–18.89)
As reported in the abstract
- LLA events
- 71 (9%)
- C-index for LLA
- 0.82 [0.77-0.87]
Further findings
| Outcome | Multivariable-adjusted HR (95% CI) | |
|---|---|---|
| Kidney failure · 12 years of follow-up | 8.97 (3.95–20.37) | |
| CVD · 12 years of follow-up | 2.50 (1.34–4.64) | |
| MACE · 12 years of follow-up | 1.91 (1.24–2.96) | |
| 0.050.21520Multivariable-adjusted HR (log scale) |
- Kidney failure — Kidney failure events
- 84 (11%)
- Kidney failure — C-index
- 0.86 [0.82-0.91]
- Cardiovascular disease (CVD) — CVD events
- 138 (17%)
- CVD — C-index
- 0.73 [0.68-0.78]
- Major adverse cardiac event (MACE) — MACE events
- 265 (32.0%)
- MACE — C-index
- 0.71 [0.68-0.75]
External validation (SURGENE)
- Similar predictive performance in the validation cohort
Original publication
Risk score for lower-limb amputation and its ability to predict major kidney and cardiovascular events in people with type 1 diabetes. Cardiovasc Diabetol. Published 29 January 2026. doi:10.
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