Babol University of Medical Sciences Caspian Journal of Surgery 3115-9087 1 3 2025 09 01 Risk Factors of Amputation in Patients With Diabetic Foot: A Comprehensive Narrative Review 121 132 728835 10.22088/caspjs.2025.2059789.1007 EN Zeinab Mohseni Afshar Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Mazandaran, Iran 0000-0002-1085-374X Arefeh Babazadeh Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Mazandaran, Iran 0000-0002-1362-7203 Soheil Ebrahimpour Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Mazandaran, Iran 0000-0003-3204-0448 Rahmat Jokar Department of Orthopedic and Trauma Surgery, Shahid Beheshti Hospital, Babol University of Medical Sciences, Iran 0000-0001-5517-3804 Mohammad Barary Student Research Committee, Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran 0000-0001-8733-9370 Journal Article 2025 06 07 Abstract<br><br>Background: Amputation remains a significant complication of diabetic foot disease, associated with substantial morbidity and mortality.<br><br>Objective: To synthesize available evidence on demographic, metabolic, vascular, infectious, and ulcer-related factors associated with amputation in adults with diabetic foot ulcers, using a transparent narrative framework augmented by systematic-narrative elements.<br><br>Methods: This is a narrative review conducted within a transparent narrative framework (no meta-analysis). We searched four databases (2000–2024): PubMed/MEDLINE, Embase, Scopus, and Cochrane Library for studies involving adults with diabetic foot ulcers reporting associations with amputation. Conference abstracts and non-indexed sources were excluded. Study selection, data extraction, and quality appraisal were performed with predefined criteria by independent reviewers. Data were organized into modifiable versus non-modifiable factors; where available.<br><br>Results: Included studies identified modifiable factors (e.g., glycemic control, infection, osteomyelitis, PAD severity, wound care adequacy) and non-modifiable factors (e.g., age, diabetes duration, comorbidity burden) associated with amputation risk. <br><br>Conclusions: Targeted multidisciplinary strategies addressing modifiable factors may reduce amputation risk. High-quality prospective studies are needed to quantify associations and inform guidelines.<br><br>diabetic patients. https://www.caspjs.com/article_728835_4d0c5c100933d07c02511eb2e954af20.pdf