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

Area of Science:

• Medical Informatics
• Public Health
• Surgical Outcomes Research

Background:

• National health registers, including the Swedish National Inpatient Register (IPR) and SwedeAmp, are managed by the National Board of Health and Welfare.
• IPR covers all surgical operations, while SwedeAmp focuses on outcomes after lower limb amputations (LLA).
• External analysis of LLA coverage rates between these registers has been lacking.

Purpose of the Study:

• To compare the coverage of SwedeAmp with IPR for LLA cases.
• To assess the accuracy of SwedeAmp in capturing LLA data.
• To identify discrepancies and establish benchmarks for common amputation levels.

Main Methods:

• Comparative analysis of LLA data from SwedeAmp and IPR (2018-2023).
• Calculation of SwedeAmp's coverage rate using IPR as the denominator.
• Assessment of patient demographics and amputation levels.

Main Results:

• IPR recorded 10,788 LLAs; SwedeAmp documented 5,246, indicating 48.6% coverage.
• Significant underrepresentation of individuals over 85 years in SwedeAmp.
• Variable coverage rates across regions and hospitals, with only 13 regions exceeding 40%.

Conclusions:

• SwedeAmp's 48.6% coverage necessitates improved data completeness for LLA records.
• Proposed benchmarks (≥60% overall, ≤36.3% transfemoral, ≤8.4% knee disarticulations, ≥55.3% transtibial) can enhance reporting consistency.
• Expanded coverage will improve SwedeAmp's utility for outcome tracking, standard setting, research, and clinical decision-making.