title: Adverse events in spine surgery in Sweden: a comparison of patient claims data and national quality register (Swespine) data .
abstract: OBJECTIVE
  Our knowledge of complications and adverse events in spinal surgery is limited, especially concerning incidence and consequences. We therefore investigated adverse events in spine surgery in Sweden by comparing patient claims data from the County Councils' Mutual Insurance Company register with data from the National Swedish Spine Register (Swespine).
  
  
  METHODS
  We analyzed patient claims (n = 182) to the insurance company after spine surgery performed between 2003 and 2005. The medical records of the patients filing these claims were reviewed and compared with Swespine data for the same period.
  
  
  RESULTS
  Two-thirds (119/182, 65%) of patients who claimed economic compensation from the insurance company were registered in Swespine. Of the 210 complications associated with these 182 claims, only 74 were listed in Swespine. The most common causes of compensated injuries (n = 139) were dural lesions (n = 40) and wound infections (n = 30). Clinical outcome based on global assessment, leg pain, disability, and quality of health was worse for patients who claimed economic compensation than for the total group of Swespine patients.
  
  
  CONCLUSIONS
  We found considerable under-reporting of complications in Swespine. Dural lesions and infections were not well recorded, although they were important reasons for problems and contributed to high levels of disability. By analyzing data from more than one source, we obtained a better understanding of the patterns of adverse events and outcomes after spine surgery.
authors: Department of Medical and Health Sciences, Linköping University, Sweden. annica.ohrn@lio.se
authors: Annica
authors: A
authors: Ohrn
authors: Anders
authors: A
authors: Olai
authors: Hans
authors: H
authors: Rutberg
authors: Per
authors: P
authors: Nilsen
authors: Hans
authors: H
authors: Tropp
mesh_terms: D004185:Disability Evaluation; D004388:Dura Mater / Q000293:injuries; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000379:methods / Q000592:standards; D017063:Outcome Assessment, Health Care; D011475:Prosthesis Failure; D011785:Quality Assurance, Health Care; D012042:Registries; D012086:Reoperation; D013122:Spinal Diseases / Q000601:surgery*; D013127:Spinal Nerves / Q000293:injuries; D013131:Spine / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology; D013548:Sweden