Draft:The Swedish Fracture Register

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Declined by SafariScribe 48 days ago. Last edited by SafariScribe 48 days ago. Reviewer: Inform author.

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The Swedish Fracture Register (SFR) is a National Quality Register (NQR) with the aim to follow outcome, function and reoperations, and mortality in patients sustaining a fracture. Since the beginning in 2011, with one department participating, it now has since 2021, full national coverage in all orthopedic departments in Sweden.^[1]

Registration process

Fractures sustained in Sweden are registered by an orthopedic surgeon, resident or A&E doctor at the ER in three steps. It starts with injury mechanism and type and low or high energy trauma. The second part is registration of the fracture, type pathological, atypical or relation to a implant. Localization (ex. forearm, spine, ankle) and classification of the fracture is specified. Classification is mainly the Arbeitsgemeinschaft für Osteosynthesenfragen/Orthopaedic Trauma Association classification (AO/OTA) where the user is guided by pictures with text. The last part treatment is non-operative or operative, the latter including specification of chosen operative method. If further treatment, either planned subsequent or secondary treatment, is registered, it is linked to the initial fracture. Mortality is automatically transferred from the Tax Agency.

Patient reported outcome

The SFR aims to evaluate the functional level, of all patient registered, one week before the accident and then one year after the accident through self-assessed questionnaires. The functional PROM used is the Short Musculoskeletal Function Assessment (SMFA). This is a validated, internationally widespread, questionnaire to measure PROM of the locomotor organs^[2] and its design makes it easy to use in community-based outcome studies. It consists of the dysfunction index, to measure the patient's function, and the bother index, which evaluates how the functional problems is a bother to the patient.

Health related quality of life is measured with EQ-5D-3L^[2], and now the EQ5D-5L^[3] which is a self-assessment scale from the Euro-QOL-group that aims to mirror health and functional level in general.

References

^ Möller, Michael; Wolf, Olof; Bergdahl, Carl; Mukka, Sebastian; Rydberg, Emilia Möller; Hailer, Nils P.; Ekelund, Jan; Wennergren, David (2022-02-11). "The Swedish Fracture Register – ten years of experience and 600,000 fractures collected in a National Quality Register". BMC Musculoskeletal Disorders. 23 (1): 141. doi:10.1186/s12891-022-05062-w. ISSN 1471-2474. PMC 8832767. PMID 35148730.
^ Swiontkowski, Marc F.; Engelberg, Ruth; Martin, Diane P.; Agel, Julie (September 1999). "Short Musculoskeletal Function Assessment Questionnaire: Validity, Reliability, and Responsiveness*". The Journal of Bone & Joint Surgery. 81 (9): 1245–60. doi:10.2106/00004623-199909000-00006. ISSN 0021-9355. PMID 10505521.
^ Devlin, Nancy J.; Brooks, Richard (April 2017). "EQ-5D and the EuroQol Group: Past, Present and Future". Applied Health Economics and Health Policy. 15 (2): 127–137. doi:10.1007/s40258-017-0310-5. ISSN 1175-5652. PMC 5343080. PMID 28194657.

[1] Möller, Michael; Wolf, Olof; Bergdahl, Carl; Mukka, Sebastian; Rydberg, Emilia Möller; Hailer, Nils P.; Ekelund, Jan; Wennergren, David (2022-02-11). "The Swedish Fracture Register – ten years of experience and 600,000 fractures collected in a National Quality Register". BMC Musculoskeletal Disorders. 23 (1): 141. doi:10.1186/s12891-022-05062-w. ISSN 1471-2474. PMC 8832767. PMID 35148730.

[2] Swiontkowski, Marc F.; Engelberg, Ruth; Martin, Diane P.; Agel, Julie (September 1999). "Short Musculoskeletal Function Assessment Questionnaire: Validity, Reliability, and Responsiveness*". The Journal of Bone & Joint Surgery. 81 (9): 1245–60. doi:10.2106/00004623-199909000-00006. ISSN 0021-9355. PMID 10505521.

[3] Devlin, Nancy J.; Brooks, Richard (April 2017). "EQ-5D and the EuroQol Group: Past, Present and Future". Applied Health Economics and Health Policy. 15 (2): 127–137. doi:10.1007/s40258-017-0310-5. ISSN 1175-5652. PMC 5343080. PMID 28194657.

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