Use of the integrated amputation risk scale in patients with diabetic foot syndrome
DOI:
https://doi.org/10.11603/2414-4533.2026.3.16583Keywords:
diabetes mellitus, pyogenic-necrotic complications, diabetic foot syndrome, amputation, multifactorial analysis, prognostic model, integrated scaleAbstract
The aim of the work: development and clinical justification of an integrated amputation risk scale for diabetic foot syndrome.
Materials and Methods. The study included 291 patients with diabetic foot syndrome who were inpatients. Among them, 84 (28.9 %) cases had lower limb amputations of various levels, which was used as the final event in building a prognostic model. A comprehensive clinical, laboratory and instrumental examination of patients was performed using modern statistical analysis methods, including correlation and multivariate regression analysis.
Results. As a result of the study, an integrated amputation risk scale in patients with diabetic foot syndrome was developed and scientifically substantiated, which is based on a comprehensive consideration of vascular, neuropathic, infectious, laboratory, local, and general somatic factors. The development of an integrated amputation risk scale has enabled us to: perform early stratification of patients by risk; optimize the choice of treatment tactics; increase the effectiveness of organ-preserving interventions; reduce the frequency of high amputations; and to some extent standardize approaches to the treatment of patients with diabetic foot syndrome.
Сonclusions. Based on the logistic regression model, a scoring system for assessing the risk of amputation was formed, which allows us to quantitatively determine the contribution of each factor. The developed scale demonstrated high predictive efficiency (AUC=0.92), good calibration ability and stability during internal validation, which confirms its reliability and reproducibility. An optimal threshold value (≥10 points) was established, which allows us to identify patients with a high risk of amputation with high sensitivity and specificity. The proposed stratification into low, moderate and high risk groups is of important clinical importance, as it contributes to the optimization of treatment tactics, timely adoption of surgical decisions and increasing the effectiveness of organ-preserving interventions.
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