MAC INDEX AS A PREDICTIVE FACTOR OF MAJOR AMPUTATION IN PATIENTS UNDERGOING MINOR AMPUTATION SECONDARY TO DIABETIC FOOT drfernandoolveracg@gmail.com

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MAC INDEX AS A PREDICTIVE FACTOR OF MAJOR AMPUTATION IN PATIENTS UNDERGOING MINOR AMPUTATION SECONDARY TO DIABETIC FOOT

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Mexico

Oral or Poster

Major lower-limb amputations represent a significant burden in patients with diabetic foot in Mexico. Minor amputations are frequently performed but often progress to major amputation. The Medial Arterial Calcification (MAC) score is a simple radiographic tool developed to quantify inframalleolar arterial calcification. This study aimed to evaluate its predictive value for adverse outcomes after minor amputation.

A retrospective review was conducted on 122 limbs that underwent minor amputation. All patients received a foot radiograph and at least 4 months of follow-up. The MAC score was assessed using a 3-point scale: 0 = absent, 1 = moderate, 2 = severe. Clinical outcomes included recurrent wound care, further minor amputations, and progression to major amputation.

Overall, 25.4% of limbs were classified as group 0, 39.3% as group 1, and 35.2% as group 2. During follow-up, 42.6% required recurrent wound care (group 0: 15.3%, group 1: 36.5%, group 2: 48.0%). Additional minor amputation was needed in 22.9% (group 0: 10.7%, group 1: 28.5%, group 2: 60.7%). Major amputation occurred in 6.55% of cases, predominantly in group 2 (75%).

Higher MAC scores were strongly associated with adverse outcomes, including repeated wound care, additional minor amputations, and major amputation. The MAC score is a reproducible, low-cost, and accessible tool for early risk stratification in patients with diabetic foot, with potential to guide closer follow-up and improve limb salvage.