Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202100872
Jornal Vascular Brasileiro
Original Article

Surgical repair of abdominal aortic aneurysms on the public health system in the largest city in Brazil: a descriptive analysis of in-hospital data on 2693 procedures over 10 years

Correção cirúrgica do aneurisma de aorta abdominal em 2.693 procedimentos ao longo de 10 anos no sistema público de saúde: uma análise descritiva na maior cidade brasileira

Marcelo Passos Teivelis; Marcelo Fiorelli Alexandrino da Silva; Nickolas Stabellini; Dafne Braga Diamante Leiderman; Claudia Szlejf; Edson Amaro Junior; Nelson Wolosker

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Abstract

Abstract: Background: From 1990 to 2015, mortality from aortic aneurysms increased 16.8% in Brazil. São Paulo is the largest city in Brazil and about 5 million people depend on the public health system there.

Objectives: To conduct an epidemiological analysis of abdominal aortic aneurysm surgeries in the city of São Paulo.

Methods: Infra-renal aortic aneurysm procedures performed over a decade (from 2008 to 2017) were studied using publicly-available platforms from the Unified Health System and DATASUS.

Results: 2693 procedures were analyzed; 66.73% were endovascular; 78.7% of patients were male; 70.7% were aged 65 years or more; 64.02% were elective hospital admissions. There were 288 in-hospital deaths (mortality: 10.69%). In-hospital mortality was lower for endovascular surgery than for open surgery; both for elective (4.13% versus 14.42%) and urgent (9.73% versus 27.94%) (p = 0.019) admissions. The highest volume hospital (n = 635) had the lowest in-hospital mortality (3.31%). USD 24,835,604.84 was paid; an average of $ 2,318.63 for elective open, $ 3,420.10 for emergency open, $ 12,157.35 for elective endovascular and $ 12,969.12 for urgent endovascular procedures. Endovascular procedure costs were statistically higher than the values paid for open surgeries (p <0.001).

Conclusions: Endovascular surgeries were performed twice as often as open surgeries; they had shorter hospital stays and lower mortality.

Material Suplementar: Clique aqui.

Keywords

abdominal aortic aneurysm, public health, vascular diseases

Resumo

Resumo: Contexto: No Brasil, a mortalidade por aneurisma de aorta aumentou 16,8% de 1990 a 2015. São Paulo é a maior cidade do Brasil, e cerca de 5 milhões de pessoas dependem do sistema público de saúde.

Objetivos: Análise epidemiológica das cirurgias do aneurisma de aorta abdominal na cidade de São Paulo.

Métodos: As cirurgias para correção do aneurisma de aorta infrarrenal realizadas no período de uma década (de 2008 a 2017) foram estudadas utilizando-se plataformas publicamente disponíveis do Sistema Único de Saúde e do Departamento de Informática do Sistema Único de Saúde.

Resultados: Foram analisados ​​2.693 procedimentos, entre os quais 66,73% eram endovasculares. Entre os pacientes, houve predominância do sexo masculino (78,7%) e daqueles com 65 anos ou mais (70,7%). Um total de 64,02% eram admissões hospitalares eletivas. Ocorreram 288 óbitos hospitalares (mortalidade: 10,69%). A mortalidade durante a internação foi menor para cirurgia endovascular do que para cirurgia aberta tanto no contexto eletivo (4,13% versus 14,42%) quanto urgente (9,73% versus 27,94%) (p = 0,019). O maior volume (n = 635) apresentou menor mortalidade intra-hospitalar (3,31%). Foi pago um total de $24.835.604,84, sendo uma média de $2.318,63 para cirurgia abertura eletiva, $3.420,10 para cirurgia abertura de emergência, $12.157,35 para cirurgia endovascular eletiva e $12.969,12 para cirurgia endovascular na urgência. Os custos dos procedimentos endovasculares foram estatisticamente superiores aos valores pagos para as cirurgias abertas (p < 0,001).

Conclusões: Foram realizadas duas vezes mais cirurgias endovasculares do que abertas, as quais apresentaram menor tempo de internação e menor mortalidade.
 

Supplementary Matterial: Clique here.

Palavras-chave

aneurisma da aorta abdominal, saúde pública, doenças vasculares

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Submitted date:
02/10/2022

Accepted date:
04/06/2022

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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