Exploring the Relationship Between SVS WIfI and IWGDF Scoring Systems and Reamputation Risk in Patients With Diabetic Foot and Peripheral Artery Disease


Bayrak A., Yalın M., Çiftçi M. U., Çelik M., Öztürk V., BAŞARAN S. H.

International Journal of Lower Extremity Wounds, cilt.25, sa.3, ss.1028-1037, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 25 Sayı: 3
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1177/15347346251333835
  • Dergi Adı: International Journal of Lower Extremity Wounds
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, DIALNET
  • Sayfa Sayıları: ss.1028-1037
  • Anahtar Kelimeler: diabetic foot, peripheral artery disease, reamputation risk, SVS WIfI and IWGDF scoring systems
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

Determining the optimal amputation level in diabetic foot (DF) and peripheral artery disease (PAD) patients is crucial for minimizing reamputation risk while preserving functionality. The Society for Vascular Surgery Wound, Ischemia, and Foot Infection (SVS WIfI) and International Working Group on Diabetic Foot (IWGDF) scoring systems are widely used for risk stratification, but their predictive value for reamputation remains unclear. The current study aimed to evaluate the predictive utility of these scoring systems for reamputation risk in patients undergoing amputations due to DF or PAD. A retrospective cohort study was conducted on 108 patients who underwent unilateral amputations due to DF or PAD between 2016 and 2021. Patients were categorized based on WIfI and IWGDF classifications, and clinical outcomes, including reamputation rates, ICU admissions, and mortality, were analyzed using logistic regression and post hoc analyses. Reamputation occurred in 41 (38%) patients. Higher WIfI (OR: 3.85, 95% CI: 2.10-7.05, P = .001) and severe IWGDF scores (OR: 3.25, 95% CI: 1.80-5.88, P = .008) significantly correlated with increased reamputation risk. Patients with high-risk scores also exhibited higher ICU admission (P = .03) and mortality rates (P = .01). Male gender (OR: 3.47, 95% CI: 1.45-8.31, P = .005), diabetes (OR: 2.32, 95% CI: 1.10-4.90, P = .027), and prolonged hospitalization (OR: 1.04, 95% CI: 1.01-1.08, P = .021) were independent predictors, while above-ankle amputations were protective for reamputation (OR: 0.22, 95% CI: 0.11-0.43, P < .001). Both scoring systems are effective in predicting reamputation risk, with WIfI providing a more comprehensive risk assessment. Combining these tools may enhance decision-making and improve patient outcomes in terms of reamputation prevention, hospital stay, ICU admission, and mortality.