Predicting the Risk of Reamputation in Patients Undergoing Lower Extremity Amputation Due to Complications of Diabetes

Objective: Lower extremity amputation (LEA) remains a common intervention for diabetic patients with advanced peripheral vascular disease and foot complications.However, reamputation rates remain high, impacting patient morbidity, rehabilitation, and survival.This study aims to identify clinical and laboratory predictors of reamputation in diabetic patients undergoing LEA and to compare characteristics between those requiring a single surgery and those undergoing additional procedures. Methods:A retrospective review was conducted on 650 diabetic patients who underwent LEA at a tertiary care center between 2020 and 2025.Patients were grouped as single-operation (Group 1, n=480) or reamputation (Group 2, n=80).Demographic, surgical, and laboratory data were analyzed.Comparative statistics were performed using t-tests, chi-square, and Mann-Whitney U tests with a significance level of p<0.05.Results: Reamputation was required in 14.2% of patients.The most common amputation level was transtibial in both groups.Cigarette use was significantly more frequent in Group 2 (40% vs. 20%, p=0.001).Although HbA1C and CRP levels were significantly higher in Group 2 (p=0.021 and p=0.001, respectively), no significant differences were found in WBC or INR values.Albumin and creatinine levels were significantly worse in Group 2 (p=0.005 and p=0.045, respectively).A greater proportion of Group 2 patients had an ASA score 3 (62.5% vs. 45%, p=0.011).Amputation side, age, and the frequency of transtibial or transfemoral amputation did not differ significantly between the groups. Conclusion:Reamputation remains a prevalent issue in diabetic LEA patients.High ASA scores were significantly associated with reoperation risk, underscoring the role of systemic disease burden.While HbA1C levels showed statistical differences, their clinical interpretation remains complex and warrants further prospective analysis.Multidisciplinary preoperative assessment is essential for improving outcomes and minimizing reamputation risk.