Predictive Value of Preoperative Inflammatory and Nutritional Indices for Revision Surgery After Major Lower Extremity Amputation in Patients With Wagner Stage 5 Diabetic Foot.
5 affiliations
- 1Department of Orthopedics and Traumatology, Kocaeli City Hospital, University of Health Science, Kocaeli, Turkey.
- 2Department of Pathology, Kocaeli City Hospital, University of Health Science, Kocaeli, Turkey.
- 3Department of Orthopedics and Traumatology, Private Silivri Anadolu Hospital, İstanbul, Turkey.
- 4Department of Orthopedics and Traumatology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey.
- 5Department of Orthopedics and Traumatology, VM Kocaeli Medical Park Hospital, Kocaeli, Turkey.
Abstract
BACKGROUND Major lower extremity amputation is a severe complication of diabetic foot disease, leading to high morbidity and repeat surgeries. Although systemic inflammatory and nutritional markers have been studied as prognostic factors in diabetic foot ulcers, their role in predicting revision surgery after major amputation is unclear. This study aims to evaluate the link between preoperative inflammatory and nutritional indices and revision surgery after major lower extremity amputation. MATERIAL AND METHODS This multicenter retrospective study reviewed medical records of patients with Wagner stage 5 diabetic foot disease who had major lower extremity amputation at 3 hospitals. Revision included stump shortening or re-amputation at a more proximal level. Patients were divided into revision and non-revision groups. Demographic characteristics, amputation side and level, and preoperative laboratory parameters were recorded. The Prognostic Nutritional Index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio were evaluated. Intergroup comparisons were performed to evaluate the association between these indices and the risk of revision surgery. RESULTS A total of 89 patients were studied; 35 (39.3%) needed revision surgery, while 54 (60.7%) healed successfully without further surgery. There were no significant differences between groups in age, sex, preoperative revascularization, amputation levels, laboratory parameters, or inflammatory and nutritional indices. No link was found between these indices and revision surgery. CONCLUSIONS Systemic inflammatory and nutritional indices before major lower extremity amputation in patients with diabetic foot were not linked to postoperative revision surgery. Risks may be more affected by local factors such as residual infection, limb perfusion, and stump viability. Future studies combining systemic biomarkers with vascular assessment could better predict revision risk.
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BibTeX
@article{gok2026predictive,
title = {{Predictive Value of Preoperative Inflammatory and Nutritional Indices for Revision Surgery After Major Lower Extremity Amputation in Patients With Wagner Stage 5 Diabetic Foot.}},
author = {Ümit Gök and Veysel Emre Çelik and Mehmet Akif Görgel and Nazlı Demir Gök and Çağdaş Pamuk and Özgür Selek and Beyzanur Işık and Ulaş Serarslan and Cengiz Erdemir and Ferat Çaboğlu},
journal = {Medical science monitor : international medical journal of experimental and clinical research},
year = {2026},
month = oct,
doi = {10.12659/msm.953681},
url = {https://europepmc.org/article/MED/42860699},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Predictive Value of Preoperative Inflammatory and Nutritional Indices for Revision Surgery After Major Lower Extremity Amputation in Patients With Wagner Stage 5 Diabetic Foot.
AU - Ümit Gök
AU - Veysel Emre Çelik
AU - Mehmet Akif Görgel
AU - Nazlı Demir Gök
AU - Çağdaş Pamuk
AU - Özgür Selek
AU - Beyzanur Işık
AU - Ulaş Serarslan
AU - Cengiz Erdemir
AU - Ferat Çaboğlu
PY - 2026
DA - 2026/10/12
JO - Medical science monitor : international medical journal of experimental and clinical research
DO - 10.12659/msm.953681
UR - https://europepmc.org/article/MED/42860699
AB - BACKGROUND Major lower extremity amputation is a severe complication of diabetic foot disease, leading to high morbidity and repeat surgeries. Although systemic inflammatory and nutritional markers have been studied as prognostic factors in diabetic foot ulcers, their role in predicting revision surgery after major amputation is unclear. This study aims to evaluate the link between preoperative inflammatory and nutritional indices and revision surgery after major lower extremity amputation. MATERIAL AND METHODS This multicenter retrospective study reviewed medical records of patients with Wagner stage 5 diabetic foot disease who had major lower extremity amputation at 3 hospitals. Revision included stump shortening or re-amputation at a more proximal level. Patients were divided into revision and non-revision groups. Demographic characteristics, amputation side and level, and preoperative laboratory parameters were recorded. The Prognostic Nutritional Index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio were evaluated. Intergroup comparisons were performed to evaluate the association between these indices and the risk of revision surgery. RESULTS A total of 89 patients were studied; 35 (39.3%) needed revision surgery, while 54 (60.7%) healed successfully without further surgery. There were no significant differences between groups in age, sex, preoperative revascularization, amputation levels, laboratory parameters, or inflammatory and nutritional indices. No link was found between these indices and revision surgery. CONCLUSIONS Systemic inflammatory and nutritional indices before major lower extremity amputation in patients with diabetic foot were not linked to postoperative revision surgery. Risks may be more affected by local factors such as residual infection, limb perfusion, and stump viability. Future studies combining systemic biomarkers with vascular assessment could better predict revision risk.
SN - 1234-1010
SN - 1643-3750
ER -