Risk factors for major amputation in patients with diabetic foot: a Meta-analysis
Bibliographic record
Abstract
Objective We conducted a systematic review and meta-analysis to clarify risk factors for major amputation in patients with diabetic foot. Methods Observational studies of risk factors for major amputation in patients with diabetic foot published before September 2017 were searched on PubMed and EMBASE. Analysis was performed using Stata 12.0 statistical software and study quality was rated by Newcastle-Ottawa scale (NOS). Results Ten observational studies was identified with 659 major amputation patients and 4 905 controls. Across studies, the overall odds ratios (OR) and 95% confidence intervals (95%CI) of significant risk factors were the depth of ulcer involved bone (OR=11.80, 95%CI 6.90-20.15), dialysis (OR=5.19, 95%CI 2.69-10.04), peripheral arterial disease (PAD) (OR=4.80, 95%CI 2.22-10.36), gangrene (OR=4.67, 95%CI 1.62-13.48), hind foot position (OR=3.64, 95%CI 1.19-11.13), decreased ankle brachial index (ABI) (OR=3.36, 95%CI 1.51-7.52), lower albumin levels (OR=3.13, 95%CI 1.82-5.37), anemia (OR=2.66, 95%CI 1.22-5.79), infection (OR=2.52, 95%CI 1.71-3.71), elevated serum creatinine (OR=1.19, 95%CI 1.08-1.31), ischemic heart disease (IHD) (OR=1.39, 95%CI 1.05-1.84). While there were no significant difference in white blood cell (WBC), C reactive protein (CRP), diabetic peripheral neuropathy (DPN), glycated hemoglobin A1c (HbA1c), hypertension and Charcot foot (all P>0.05). Conclusion Factors associated with major amputation in patients with diabetic foot are the depth of ulcer involved bone, dialysis, PAD, gangrene, hind foot position, decreased ABI, lower albumin levels, IHD, there is no relation with WBC, CRP, HbA1c, DPN, hypertension and charcot foot. Key words: Diabetic foot; Risk factors; Meta-analysis; Major amputation
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.021 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.017 | 0.048 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".