Development and validation of a prediction model for amputation risk in patients with diabetic foot ulcers based on systematic review and meta-analysis

HAN Weidong; FAN Yiming; CHEN Pan; HU Nan; HU Shiqi; XIONG Te; YIN Rui

doi:10.16016/j.2097-0927.202506048

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Development and validation of a prediction model for amputation risk in patients with diabetic foot ulcers based on systematic review and meta-analysis

Clinical Medicine | 更新时间：2025-09-28

- Development and validation of a prediction model for amputation risk in patients with diabetic foot ulcers based on systematic review and meta-analysis
- Journal of Army Medical University Vol. 47, Issue 18, Pages: 2262-2271(2025)
- 作者机构：
  
  陆军军医大学（第三军医大学）第一附属医院皮肤科，重庆
- 作者简介：
- 基金信息：
  
  the Joint Medical Research Project of Chongqing Science and Technology Health Commission and Chongqing Health Commission(2022ZDXM014)
- DOI：10.16016/j.2097-0927.202506048
  CLC： R181.23;R587.2;R687.31
- Received：17 June 2025，
  
  Revised：2025-08-09，
  
  Accepted：15 August 2025，
  
  Published：30 September 2025
- 稿件说明：
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韩炜东，范一鸣，陈盼，等.基于系统评价和Meta分析的糖尿病足溃疡患者截肢风险预测模型的开发和验证［J］.陆军军医大学学报，2025，47（18）：2262-2271.DOI：10.16016/j.2097-0927.202506048.

HAN WEIDONG，FAN YIMING，CHEN PAN，et al.Development and validation of a prediction model for amputation risk in patients with diabetic foot ulcers based on systematic review and meta-analysis［J］.J Army Med Univ，2025，47（18）：2262-2271.DOI：10.16016/j.2097-0927.202506048.
韩炜东，范一鸣，陈盼，等.基于系统评价和Meta分析的糖尿病足溃疡患者截肢风险预测模型的开发和验证［J］.陆军军医大学学报，2025，47（18）：2262-2271.DOI：10.16016/j.2097-0927.202506048. DOI：

HAN WEIDONG，FAN YIMING，CHEN PAN，et al.Development and validation of a prediction model for amputation risk in patients with diabetic foot ulcers based on systematic review and meta-analysis［J］.J Army Med Univ，2025，47（18）：2262-2271.DOI：10.16016/j.2097-0927.202506048. DOI：

摘要

目的

基于系统评价和Meta分析开发并验证一种预测糖尿病足溃疡（diabetic foot ulcers，DFU）患者截肢风险的模型。

方法

采用主题词+自由词的检索方式，检索关于研究DFU患者截肢风险因素的文献。经筛选最终纳入37项队列研究，采用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale，NOS）进行质量评价。对DFU的截肢风险因素进行Meta分析。DFU截肢风险预测模型纳入Meta分析中具有统计学意义的风险因素，根据各风险因素合并的比值比（odds ratio， OR）计算其相应

系数并进行评分赋值，建立评分制模型。收集2021年至2023年于陆军军医大学第一附属医院内分泌科住院的453例DFU患者的临床数据作为验证队列，对模型进行验证。模型性能评估基于受试者工作特征曲线下面积（area under the curve of receiver operating characteristic，AUC），通过灵敏度和特异性计算最大约登指数来确定最佳界值分数。

结果

Meta分析显示在11 779例DFU患者中，累积截肢率约34.65%。最终的风险预测模型纳入5个风险因素，包括坏疽［

=11.92（5.86~24.24）］、溃疡深度［

=4.93（2.52~9.64）］、骨髓炎［

=3.19（2.36~4.29）］、既往截肢史［

=3.19（2.00~5.09）］和下肢动脉疾病［

=3.10（2.31~4.17）］。根据各风险因素的权重，模型总分为76分，最佳界值分数为36.5分。预测模型性能良好，

AUC

=0.864（0.824~0.903），灵敏度为

0.743，特异性为0.859，准确率为83.00%。

结论

本研究开发了一种基于风险因素评分的DFU截肢风险预测模型，模型具有良好的区分度和校准度，为DFU截肢相关的临床研究和临床决策提供有效的科学依据。

Abstract

Objective

To develop and validate a prediction model for risk of amputation in patients with diabetic foot ulcers (DFU) based on systematic review and meta-analysis.

Methods

The studies on the risk factors of amputation in DFU patients was retrieved by using subject words+free words. After screening

37 cohort studies were finally included

and the Newcastle-Ottawa scale (NOS) was used for quality evaluation. Meta-analysis was performed on the risk factors of amputation in DFU. Then a prediction model for DFU amputation risk were constructed based on the statistically significant risk factors in the meta-analysis. The corresponding

value was calculated based on the combined odds ratio (OR) value of each risk factor

and each risk factor was scored to establish a scoring system model. The clinical data of 453 DFU patients hospitalized in our department from 2021 to 2023 were collected as a validation cohort. Receiver operating characteristic (ROC) curve analysis was used to evaluate the model performance. The area under the curve (AUC) was calculated

and the optimal cutoff score was determined by calculation of the maximum Youden index through sensitivity and specificity.

Results

Our meta-analysis showed a cumulative amputation rate of approximately 34.65% in 11 779 DFU patients. The final risk prediction models include gangrene [

=11.92 (5.86~24.24)

]

ulcer depth [

=4.93 (2.52~9.64)

]

osteomyelitis [

=3.19 (2.36~4.29)

]

previous amputation history [

=3.19 (2.00~5.09)

]

and lower extremity arterial disease [

=3.10 (2.31~4.17)

]

. According to the weights of each risk factor

the total score of the model is 76

and the

optimal cut-off score is 36.5. The prediction model performed well

with an AUC value of 0.864 (0.824

0.903)

a sensitivity of 0.743

a specificity of 0.859

and an accuracy rate of 83.00%.

Conclusion

A prediction model for DFU amputation risk is developed based on risk factor scoring

and has good discrimination and calibration

providing effective scientific basis for clinical research and clinical decision-making related to DFU amputation.

关键词

Keywords

references

LIPSKY B A ， BERENDT A R ， CORNIA P B ， et al . 2012 Infectious Diseases Society of America clinical practice guideline for the diagnosis and treatment of diabetic foot infections ［J］. Clin Infect Dis ， 2012 ， 54 （ 12 ）： e132-73 . DOI： 10.1093/cid/cis346 http://dx.doi.org/10.1093/cid/cis346 .

OUYANG H ， TANG Y ， YANG F ， et al . Platelet-rich plasma for the treatment of diabetic foot ulcer： a systematic review ［J］. Front Endocrinol ， 2023 ， 14 ： 1256081 . DOI： 10.3389/fendo.2023.1256081 http://dx.doi.org/10.3389/fendo.2023.1256081 .

HINGORANI A ， LAMURAGLIA G M ， HENKE P ， et al . The management of diabetic foot： a clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine ［J］. J Vasc Surg ， 2016 ， 63 （ 2 Suppl ）： 3S - 21S . DOI： 10.1016/j.jvs.2015.10.003 http://dx.doi.org/10.1016/j.jvs.2015.10.003 .

HAMBLETON I R ， JONNALAGADDA R ， DAVIS C R ， et al . All-cause mortality after diabetes-related amputation in Barbados： a prospective case-control study ［J］. Diabetes Care ， 2009 ， 32 （ 2 ）： 306 - 307 . DOI： 10.2337/dc08-1504 http://dx.doi.org/10.2337/dc08-1504 .

XU S M ， HERRERA A ， SCHECHTER C ， et al . The risk of and associated demographic and laboratory variables for amputations for inpatients with diabetic foot ulcers ［J］. Endocr Pract ， 2024 ， 30 （ 8 ）： 758 - 764 . DOI： 10.1016/j.eprac.2024.04.019 http://dx.doi.org/10.1016/j.eprac.2024.04.019 .

JEYARAMAN K ， BERHANE T ， HAMILTON M ， et al . Amputations in patients with diabetic foot ulcer： a retrospective study from a single centre in the Northern Territory of Australia ［J］. ANZ J Surg ， 2019 ， 89 （ 7/8 ）： 874 - 879 . DOI： 10.1111/ans.15351 http://dx.doi.org/10.1111/ans.15351 .

AYDIN K ， ISILDAK M ， KARAKAYA J ， et al . Change in amputation predictors in diabetic foot disease： effect of multidisciplinary approach ［J］. Endocrine ， 2010 ， 38 （ 1 ）： 87 - 92 . DOI： 10.1007/s12020-010-9355-z http://dx.doi.org/10.1007/s12020-010-9355-z .

JEON B J ， CHOI H J ， KANG J S ， et al . Comparison of five systems of classification of diabetic foot ulcers and predictive factors for amputation ［J］. Int Wound J ， 2017 ， 14 （ 3 ）： 537 - 545 . DOI： 10.1111/iwj.12642 http://dx.doi.org/10.1111/iwj.12642 .

JEONG E G ， CHO S S ， LEE S H ， et al . Depth and combined infection is important predictor of lower extremity amputations in hospitalized diabetic foot ulcer patients ［J］. Korean J Intern Med ， 2018 ， 33 （ 5 ）： 952 - 960 . DOI： 10.3904/kjim.2016.165 http://dx.doi.org/10.3904/kjim.2016.165 .

PENG B C ， MIN R ， LIAO Y Q ， et al . Development of predictive nomograms for clinical use to quantify the risk of amputation in patients with diabetic foot ulcer ［J］. J Diabetes Res ， 2021 ， 2021 ： 6621035 . DOI： 10.1155/2021/6621035 http://dx.doi.org/10.1155/2021/6621035 .

LEUNG H B ， HO Y C ， CARNETT J ， et al . Diabetic foot ulcers in the Hong Kong Chinese population： retrospective study ［J］. Hong Kong Med J ， 2001 ， 7 （ 4 ）： 350 - 355 .

BLUMBERG S N ， WARREN S M . Disparities in initial presentation and treatment outcomes of diabetic foot ulcers in a public， private， and Veterans Administration hospital ［J］. J Diabetes ， 2014 ， 6 （ 1 ）： 68 - 75 . DOI： 10.1111/1753-0407.12050 http://dx.doi.org/10.1111/1753-0407.12050 .

MUSA I R ， AHMED M O N ， SABIR E I ， et al . Factors associated with amputation among patients with diabetic foot ulcers in a Saudi population ［J］. BMC Res Notes ， 2018 ， 11 （ 1 ）： 260 . DOI： 10.1186/s13104-018-3372-z http://dx.doi.org/10.1186/s13104-018-3372-z .

GUO Z ， YUE C ， QIAN Q ， et al . Factors associated with lower-extremity amputation in patients with diabetic foot ulcers in a Chinese tertiary care hospital ［J］. Int Wound J ， 2019 ， 16 （ 6 ）： 1304 - 1313 . DOI： 10.1111/iwj.13190 http://dx.doi.org/10.1111/iwj.13190 .

LI X ， XIAO T ， WANG Y Z ， et al . Incidence， risk factors for amputation among patients with diabetic foot ulcer in a Chinese tertiary hospital ［J］. Diabetes Res Clin Pract ， 2011 ， 93 （ 1 ）： 26 - 30 . DOI： 10.1016/j.diabres.2011.03.014 http://dx.doi.org/10.1016/j.diabres.2011.03.014 .

ZUBAIR M ， MALIK A ， AHMAD J . Incidence， risk factors for amputation among patients with diabetic foot ulcer in a North Indian tertiary care hospital ［J］. Foot （Edinb）， 2012 ， 22 （ 1 ）： 24 - 30 . DOI： 10.1016/j.foot.2011.09.003 http://dx.doi.org/10.1016/j.foot.2011.09.003 .

YESIL S ， AKINCI B ， YENER S ， et al . Predictors of amputation in diabetics with foot ulcer： single center experience in a large Turkish cohort ［J］. Hormones （Athens）， 2009 ， 8 （ 4 ）： 286 - 295 . DOI： 10.14310/horm.2002.1245 http://dx.doi.org/10.14310/horm.2002.1245 .

UGWU E ， ADELEYE O ， GEZAWA I ， et al . Predictors of lower extremity amputation in patients with diabetic foot ulcer： findings from MEDFUN， a multi-center observational study ［J］. J Foot Ankle Res ， 2019 ， 12 ： 34 . DOI： 10.1186/s13047-019-0345-y http://dx.doi.org/10.1186/s13047-019-0345-y .

SALEEM S ， HAYAT N ， AHMED I ， et al . Risk factors associated with poor outcome in diabetic foot ulcer patients ［J］. Turk J Med Sci ， 2017 ， 47 （ 3 ）： 826 - 831 . DOI： 10.3906/sag-1602-119 http://dx.doi.org/10.3906/sag-1602-119 .

FERREIRA L ， CARVALHO A ， CARVALHO R . Short-term predictors of amputation in patients with diabetic foot ulcers ［J］. Diabetes Metab Syndr ， 2018 ， 12 （ 6 ）： 875 - 879 . DOI： 10.1016/j.dsx.2018.05.007 http://dx.doi.org/10.1016/j.dsx.2018.05.007 .

WANG L R ， LI Q ， CHEN X ， et al . Clinical characteristics and risk factors of lower extremity amputation in patients with diabetic foot ［J］. Pak J Med Sci ， 2022 ， 38 （ 8 ）： 2253 - 2258 . DOI： 10.12669/pjms.38.8.5635 http://dx.doi.org/10.12669/pjms.38.8.5635 .

PERNG C K ， CHOU H Y ， CHIU Y J . Identifying major predictors of lower-extremity amputation in patients with diabetic foot ulcers ［J］. J Chin Med Assoc ， 2021 ， 84 （ 3 ）： 285 - 289 . DOI： 10.1097/JCMA.0000000000000473 http://dx.doi.org/10.1097/JCMA.0000000000000473 .

SAYINER Z A ， CAN F I ， AKARSU E . Patients' clinical charecteristics and predictors for diabetic foot amputation ［J］. Prim Care Diabetes ， 2019 ， 13 （ 3 ）： 247 - 251 . DOI： 10.1016/j.pcd.2018.12.002 http://dx.doi.org/10.1016/j.pcd.2018.12.002 .

KURNIAWATI A ， ISMIARTO Y D ， HSU I L . Prognostic factors for lower extremity amputation in diabetic foot ulcer patients ［J］. J Acute Med ， 2019 ， 9 （ 2 ）： 59 - 63 . DOI： 10.6705/j.jacme.201906_9（2）.0003 http://dx.doi.org/10.6705/j.jacme.201906_9（2）.0003 .

LEE J H ， YOON J S ， LEE H W ， et al . Risk factors affecting amputation in diabetic foot ［J］. Yeungnam Univ J Med ， 2020 ， 37 （ 4 ）： 314 - 320 . DOI： 10.12701/yujm.2020.00129 http://dx.doi.org/10.12701/yujm.2020.00129 .

BEKELE F ， CHELKEBA L ， FEKADU G ， et al . Risk factors and outcomes of diabetic foot ulcer among diabetes mellitus patients admitted to Nekemte referral hospital， western Ethiopia： Prospective observational study ［J］. Ann Med Surg （Lond）， 2020 ， 51 ： 17 - 23 . DOI： 10.1016/j.amsu.2020.01.005 http://dx.doi.org/10.1016/j.amsu.2020.01.005 .

MOON K C ， SON J W ， HAN S K ， et al . Risk factors for major amputation for midfoot ulcers in hospitalized patients with diabetes： a retrospective study ［J］. J Wound Ostomy Continence Nurs ， 2021 ， 48 （ 2 ）： 163 - 168 . DOI： 10.1097/WON.0000000000000735 http://dx.doi.org/10.1097/WON.0000000000000735 .

ZHANG X Y ， LI Q W ， ZHOU X P ， et al . Risk factors for amputation in diabetic foot ulcers： a retrospective analysis ［J］. Int Wound J ， 2024 ， 21 （ 4 ）： e14832 . DOI： 10.1111/iwj.14832 http://dx.doi.org/10.1111/iwj.14832 .

AKINCI B ， YENER S ， YESIL S ， et al . Acute phase reactants predict the risk of amputation in diabetic foot infection ［J］. J Am Podiatr Med Assoc ， 2011 ， 101 （ 1 ）： 1 - 6 . DOI： 10.7547/1010001 http://dx.doi.org/10.7547/1010001 .

ZENGIN B ， YUZUGULDU B ， SIMSIR I Y ， et al . An index to prevent major limb amputations in diabetic foot ［J］. Endocr Regul ， 2023 ， 57 （ 1 ）： 80 - 91 . DOI： 10.2478/enr-2023-0010 http://dx.doi.org/10.2478/enr-2023-0010 .

YUZUGULDU B ， ZENGIN B ， SIMSIR I Y ， et al . An overview of risk factors for diabetic foot amputation： an observational， single-centre， retrospective cohort study ［J］. touchREV Endocrinol ， 2023 ， 19 （ 1 ）： 85 - 93 . DOI： 10.17925/EE.2023.19.1.85 http://dx.doi.org/10.17925/EE.2023.19.1.85 .

CHEN Y ， ZHUANG J ， YANG C Z . Development of a major amputation prediction model and nomogram in patients with diabetic foot ［J］. Postgrad Med J ， 2024 ， 100 （ 1190 ）： 908 - 916 . DOI： 10.1093/postmj/qgae087 http://dx.doi.org/10.1093/postmj/qgae087 .

BEANEY A J ， NUNNEY I ， GOODAY C ， et al . Factors determining the risk of diabetes foot amputations： a retrospective analysis of a tertiary diabetes foot care service ［J］. Diabetes Res Clin Pract ， 2016 ， 114 ： 69 - 74 . DOI： 10.1016/j.diabres.2016.02.001 http://dx.doi.org/10.1016/j.diabres.2016.02.001 .

SOLIMAN M M ， BAKR A H ， GABER M A E ， et al . High density lipoprotein （HDL） level may be a risk factor of lower extremities amputation （LEA） in patients with diabetic foot ulcer （DFU）［J］. Res J Pharm ， Biol Chem Sci， 2020 ， 11 （ 2 ）： 158 - 69 . DOI： 10.33887/rjpbcs/2020.11.2.17 http://dx.doi.org/10.33887/rjpbcs/2020.11.2.17

ABBAS Z G ， CHOCKALINGAM N ， LUTALE J K ， et al . Predicting the risk of amputation and death in patients with diabetic foot ulcer. A long-term prospective cohort study of patients in Tanzania ［J］. Endocrinol Diabetes Metab ， 2022 ， 5 （ 3 ）： e00336 . DOI： 10.1002/edm2.336 http://dx.doi.org/10.1002/edm2.336 .

LEE D W ， KWAK S H ， KIM J H ， et al . Prediction of diabetic foot amputation using newly revised DIRECT coding system： Comparison of accuracy with that of five existing classification systems ［J］. Int Wound J ， 2023 ， 20 （ 2 ）： 359 - 371 . DOI： 10.1111/iwj.13884 http://dx.doi.org/10.1111/iwj.13884 .

CHE D H ， JIANG Z W ， XIANG X J ， et al . Predictors of amputation in patients with diabetic foot ulcers： a multi-centre retrospective cohort study ［J］. Endocrine ， 2024 ， 85 （ 1 ）： 181 - 189 . DOI： 10.1007/s12020-024-03704-8 http://dx.doi.org/10.1007/s12020-024-03704-8 .

PICKWELL K ， SIERSMA V ， KARS M ， et al . Predictors of lower-extremity amputation in patients with an infected diabetic foot ulcer ［J］. Diabetes Care ， 2015 ， 38 （ 5 ）： 852 - 857 . DOI： 10.2337/dc14-1598 http://dx.doi.org/10.2337/dc14-1598 .

UYSAL S ， ARDA B ， TAŞBAKAN M I ， et al . Risk factors for amputation in patients with diabetic foot infection： a prospective study ［J］. Int Wound J ， 2017 ， 14 （ 6 ）： 1219 - 1224 . DOI： 10.1111/iwj.12788 http://dx.doi.org/10.1111/iwj.12788 .

PEMAYUN T G D ， NAIBAHO R M ， NOVITASARI D ， et al . Risk factors for lower extremity amputation in patients with diabetic foot ulcers： a hospital-based case-control study ［J］. Diabet Foot Ankle ， 2015 ， 6 ： 29629 . DOI： 10.3402/dfa.v6.29629 http://dx.doi.org/10.3402/dfa.v6.29629 .

KANG H ， CHOI S ， PARK Y G ， et al . Risk factors for major lower limb amputation and effect of endovascular revascularization in patients with diabetic foot wound ［J］. Indian J Orthop ， 2024 ， 58 （ 4 ）： 379 - 386 . DOI： 10.1007/s43465-024-01100-y http://dx.doi.org/10.1007/s43465-024-01100-y .

SÁNCHEZ C A ， DE VRIES E ， GIL F ， et al . Prediction model for lower limb amputation in hospitalized diabetic foot patients using classification and regression trees ［J］. Foot Ankle Surg ， 2024 ， 30 （ 6 ）： 471 - 479 . DOI： 10.1016/j.fas.2024.03.007 http://dx.doi.org/10.1016/j.fas.2024.03.007 .

OEI C W ， CHAN Y M ， ZHANG X J ， et al . Risk prediction of diabetic foot amputation using machine learning and explainable artificial intelligence ［J］. J Diabetes Sci Technol ， 2025 ， 19 （ 4 ）： 1008 - 1022 . DOI： 10.1177/19322968241228606 http://dx.doi.org/10.1177/19322968241228606 .

STEFANOPOULOS S ， QIU Q ， REN G ， et al . A machine learning model for prediction of amputation in diabetics ［J］. J Diabetes Sci Technol ， 2024 ， 18 （ 4 ）： 874 - 881 . DOI： 10.1177/19322968221142899 http://dx.doi.org/10.1177/19322968221142899 .

ZHAO F Y ， XIE L X ， WENG Z Y ， et al . Combined with dynamic serum proteomics and clinical follow-up to screen the serum proteins to promote the healing of diabetic foot ulcer ［J］. Endocrine ， 2024 ， 84 （ 2 ）： 365 - 379 . DOI： 10.1007/s12020-023-03579-1 http://dx.doi.org/10.1007/s12020-023-03579-1 .

HONG S C ， CHEN Y H ， LIN Y ， et al . Personalized prediction of diabetic foot ulcer recurrence in elderly individuals using machine learning paradigms ［J］. Technol Health Care ， 2024 ， 32 （ S1 ）： 265 - 276 . DOI： 10.3233/THC-248023 http://dx.doi.org/10.3233/THC-248023 .

WU P Y ， YU Y L ， ZHAO W R ， et al . Identifying and validating extracellular matrix-related gene CTSH in diabetic foot ulcer using bioinformatics and machine learning ［J］. J Inflamm Res ， 2024 ， 17 ： 5871 - 5887 . DOI： 10.2147/JIR.S467507 http://dx.doi.org/10.2147/JIR.S467507 .

CHO S K ， MATTKE S ， GORDON H ， et al . Development of a model to predict healing of chronic wounds within 12 weeks ［J］. Adv Wound Care ， 2020 ， 9 （ 9 ）： 516 - 524 . DOI： 10.1089/wound.2019.1091 http://dx.doi.org/10.1089/wound.2019.1091 .

WANG N ， YANG B H ， WANG G ， et al . A meta-analysis of the relationship between foot local characteristics and major lower extremity amputation in diabetic foot patients ［J］. J Cell Biochem ， 2019 ， 120 （ 6 ）： 9091 - 9096 . DOI： 10.1002/jcb.28183 http://dx.doi.org/10.1002/jcb.28183 .

陈红梅，朱迪，肖黎，等 . 糖尿病足并发缺血性肠病1例及文献复习［J］. 空军军医大学学报， 2023 ， 14 （ 12 ）： 1241 - 1244 . DOI： 10.13276/j.issn.2097-1656.2023.12.018 http://dx.doi.org/10.13276/j.issn.2097-1656.2023.12.018 .

CHEN H M ， ZHU D ， XIAO L ， et al . A case of diabetic foot complicated with ischemic bowel disease and literature review ［J］. J Air Force Med Univ ， 2023 ， 14 （ 12 ）： 1241 - 1244 . DOI： 10.13276/j.issn.2097-1656. 2023.12.018 http://dx.doi.org/10.13276/j.issn.2097-1656.2023.12.018 .

SENNEVILLE É ， ALBALAWI Z ， VAN ASTEN S A ， et al . IWGDF/IDSA guidelines on the diagnosis and treatment of diabetes-related foot infections （IWGDF/IDSA 2023）［J］. Clin Infect Dis ， 2023 ： ciad527 . DOI： 10.1093/cid/ciad527 http://dx.doi.org/10.1093/cid/ciad527 .

ARMSTRONG D G ， BOULTON A J M ， BUS S A . Diabetic foot ulcers and their recurrence ［J］. N Engl J Med ， 2017 ， 376 （ 24 ）： 2367 - 2375 . DOI： 10.1056/NEJMra1615439 http://dx.doi.org/10.1056/NEJMra1615439 .

ARMSTRONG D G ， WROBEL J ， ROBBINS J M . Guest Editorial： are diabetes-related wounds and amputations worse than cancer？［J］. Int Wound J ， 2007 ， 4 （ 4 ）： 286 - 287 . DOI： 10.1111/j.1742-481X.2007.00392.x http://dx.doi.org/10.1111/j.1742-481X.2007.00392.x .

LI S J ， BIAN S Z ， WANG H Q ， et al . Platelet/hemoglobin ratio predicts severity of diabetic foot ulcer： a report of 345 cases ［J］. J Army Med Univ ， 2024 ， 46 （ 9 ）： 1057 - 1063 . DOI： 10.16016/j.2097-0927.202312077 http://dx.doi.org/10.16016/j.2097-0927.202312077 .

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Predictive nomogram for central lymph node metastasis in papillary thyroid microcarcinoma based on CT-clinical data

Risk factors for postoperative respiratory failure in patients undergoing cardiovascular surgery and construction of a prediction model

Construction and validation of prediction model for cervical cancer recurrence based on systemic inflammation response index and clinicopathological parameters

Incidence and risk factors of acute renal injury after Stanford type A aortic dissections

Predictive value and risk factors of embryo implantation site for placenta previa

Related Author

FAN Rui

HE Xingyun

DU Junze

CHEN Linli

ZHOU Fuchao

LIU Xiang

LU Kaizhi

SHAO Jianliang

Related Institution

Department of Radiology, First Affiliated Hospital, Army Medical University (Third Military Medical University)

Department of Breast and Thyroid Surgery, First Affiliated Hospital, Army Medical University (Third Military Medical University)

Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University

Department of Anesthesiology， First Affiliated Hospital， Army Medical University （Third Military Medical University）

Department of Gynecology and Obstetrics， the First Affiliated Hospital of Chongqing Medical University

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