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. 2024 Nov 19;7(2):44089.
doi: 10.33137/cpoj.v7i2.44089. eCollection 2024.

Evaluation of the SwedeAmp database: Focus on coverage and amputation level rates

A G Johannesson  1 , R Scheving  2 , K L Westlund  2 , T Fridriksson  2
Affiliations

Evaluation of the SwedeAmp database: Focus on coverage and amputation level rates

A G Johannesson et al. Can Prosthet Orthot J. .

Abstract

Background: The National Board of Health and Welfare manages several national registers in Sweden. This includes the Swedish National Inpatient Register (IPR), covering all surgical operations, and SwedeAmp, focusing on outcomes after lower limb amputations (LLA). However, coverage rates of amputation levels between these registers have not been externally analyzed.

Objective: To compare SwedeAmp's coverage with IPR for LLA cases and to assess SwedeAmp's accuracy in capturing LLA data. The goal of this study was also to identify potential discrepancies and establish benchmarks for common amputation levels.

Methodology: Data from both registers, covering the years 2018 to 2023, were compared regarding the amputation levels and patient demographics. The coverage rate of the SwedeAmp register was calculated using SwedeAmp data as the numerator and IPR data as the denominator.

Findings: The IPR registry recorded 10,788 LLAs across 21 regions (67 hospitals). The SwedeAmp documented 5,246 LLAs covering 17 regions (36 hospitals), leaving 5,542 amputations unaccounted for, mainly due to regions or hospitals not participating in the SwedeAmp registry and lower registration rates in some areas. Key findings include:Achieving full coverage in SwedeAmp (17 regions) would require registering 9,305 LLAs.Both men and women over 85 years were significantly underrepresented.Thirteen regions in SwedeAmp obtained more than 40% coverage rate.5 regions had more than 50% rate of above-knee amputations (range: 50.9% - 68.2%).8 regions reporting more than 50% rate of below-knee amputations (range: 53.1% - 88.9%).Among the 67 hospitals performing LLAs, 36 reported to SwedeAmp. Six of these hospitals performed fewer than 10 LLAs over a six-year period.

Conclusion: SwedeAmp captured 48.6% of initial LLAs in Sweden, highlighting the need for improved data completeness in LLA records, especially as only 13 regions achieved over 40% Coverage. For hospitals performing regular amputation, the proposed benchmark-coverage of ≥60%, with ≤36.3% for transfemoral amputation (TF), ≤8.4% for knee disarticulations (KD), and ≥55.3% for transtibial amputations (TT) - could serve as a target to enhance consistency and accuracy in reporting. Expanding coverage can improve the register's utility in tracking outcomes, setting national standards, aiding research, and supporting clinical decision-making.

Keywords: Amputation; Amputation Rates; Knee Disarticulation; Lower Limb Amputation; Rehabilitation; SwedeAmp; Sweden; Transfemoral; Transtibial.

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Conflict of interest statement

Anton G. Johannesson is an employee of Össur Clinics, which provides services to prosthetic and orthotics clinics. Reynir Scheving, Karolin Lindgren Westlund, and Thor Fridriksson are all employed by Össur Iceland ehf, Medical Office in Reykjavik, Iceland.

Figures

Figure 1:
Figure 1:
A: Geographical maps showing the Swedish population (by region). B: SwedeAmp coverage rate in % by regions compared to IPR.
Figure 2:
Figure 2:
SwedeAmp coverage ratio by age groups (2018–2023).
Figure 3:
Figure 3:
SwedeAmp coverage ratio trends (2018–2023).
See this image and copyright information in PMC

References

    1. National patient register [Internet]. Socialstyrelsen. 2023; [cited 2024, Aug 15]. Available from: https://www.socialstyrelsen.se/en/statistics-and-data/registers/national...
    1. Goodwin VA, Low MSA, Quinn TJ, Cockcroft EJ, Shepherd V, Evans PH, et al.. Including older people in health and social care research: Best practice recommendations based on the INCLUDE framework. Age Ageing. 2023;52(6):afad082. DOI: 10.1093/ageing/afad082 - DOI - PMC - PubMed
    1. Weiss RJ, Kärrholm J, Rolfson O, Hailer NP. Increased early mortality and morbidity after total hip arthroplasty in patients with socioeconomic disadvantage: A report from the Swedish hip arthroplasty register. Acta Orthop. 2019;90(3):264–9. DOI: 10.1080/17453674.2019.1598710 - DOI - PMC - PubMed
    1. Statistical database [Internet]. Statistics Sweden. [cited 2024, Aug 19]. Available from: https://www.statistikdatabasen.scb.se/pxweb/en/ssd/START__BE__BE0101/
    1. Licence to practise [Internet]. Socialstyrelsen. [cited 2024, Aug 18]. Available from: https://www.socialstyrelsen.se/en/

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