National trends, incidence and regional variations in lower extremity amputations in Sweden, 2008–2024: a register-based study

Abstract Lower extremity amputation (LEA) trends are changing worldwide. This population-based study aimed to describe the incidence, temporal trends, demographic distribution, and regional variation of LEA in Sweden from 2008 to 2024. Data were obtained from the Swedish National Patient Register, and individuals undergoing LEA from toe to hip-level were identified using NOMESCO procedure codes. Incidence were calculated per 100,000 inhabitants/year and analyzed by sex, age, and geographic region. A total of 53,005 patients underwent LEA during the study period, corresponding to an overall incidence of 37.9 per 100,000 person-years. Men had significantly higher incidence than women (p < 0.001). Incidence declined over time, with an estimated future decrease of 0.5% per year in men and 1.9% per year in women. The reduction was mainly driven by decreasing incidence of transtibial amputations and knee disarticulations. Incidence was highest among older individuals and varied geographically, with higher incidence observed in rural regions compared with urban areas. In conclusion, the incidence of LEA in Sweden decreased during the study period, although substantial differences by sex, age, and region persist. Understanding these patterns may help guide preventive strategies and improve equity in healthcare access.